IMPAIRMENT OF NASAL MUCOCILIARY CLEARANCE DURING BONE-MARROW TRANSPLANTATION

Transient mucositis occurs in almost all patients receiving bone marro w transplantation (BMT) but it is not known whether airway mucociliary transport is impaired during this period. We hypothesized that the pr eparative regimen associated with BMT impairs mucociliary clearance du ring the peri-transplant period. To test this hypothesis we determined nasal saccharine transit time (STT) and a mucositis score daily throu ghout the peri-transplant hospitalization in 13 patients receiving BMT . STT was prolonged in all patients at some time during the peri-trans plant period and mucociliary clearance was ineffective in 12 of 13 pat ients for an average of 22% of the days. STT was most prolonged (about 155% of baseline) in the 2 week period following marrow infusion and correlated with the appearance of mucositis. STT returned to baseline values within 30 days after marrow infusion in all but one patient. Th ese findings demonstrate that nasal mucociliary clearance is significa ntly impaired in most patients during BMT, if only temporarily. This d ecrease in local airway host defense may explain, in part, the increas ed risk of upper respiratory infections that these patients experience .