Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure: A randomized controlled trial

Early warning and prevention of pneumonia in acute leukemia by patient education, spirometry, and positive expiratory pressure: A randomized controlled trial

Moller, T, (2016) American Journal of Hematology, (Link to abstract)


This study is a randomized control trial studying the applicability of daily spirometry as an early warning tool for pneumonia in patients undergoing treatment for AML, and also explored if the addition of positive expiratory pressure (PEEP) might be effective in preventing the development of pneumonia. 80 adult AML patients were enrolled on the trial and were randomized to daily spirometry with or without PEEP. A FEV1 value of 76-80% was found to be highly sensitive and specific for pneumonia development, and there was a significant decrease in the incidence of pneumonia in the patients who were randomized to the PEEP arm (2.17 per 1000 days vs 6.52 per 1000 days, P = 0.021). The authors suggest that daily self-administered spirometry along with the use of PEEP should be part of the standard of care for AML patients undergoing induction chemotherapy.


* Daily self-administered spirometry may be a useful early warning tool for pneumonia in patients undergoing treatment for AML, and the addition of positive expiratory pressure may help prevent episodes of pneumonia. This approach is not feasible in young pediatric patients and the usefulness in children has not been proven.