Laboratory and Diagnostic Studies Sandra A. Mitchell, CRNP, M.Sc.N., AOCN National Institutes of Health Bethesda, MD.

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Laboratory and Diagnostic Studies Sandra A. Mitchell, CRNP, M.Sc.N., AOCN National Institutes of Health Bethesda, MD

Platelet count Total white blood cell count Percentage of eosinophils Record value and upper limit of normal (ULN) Blood Counts

Liver Function Tests Total serum bilirubin ALT/SGPT Alkaline phosphatase Record value and upper limit of normal (ULN)

Valuable tool in evaluating respiratory function in patients with chronic GVHD. PFTs may be unreliable in patients younger than five years. Compares measured values for an individual patient with normative values derived from population studies. Percent predicted normal is used to define abnormality and to grade the severity of the abnormality. Pulmonary Function Tests (PFTs)

PFT components of greatest significance in assessing chronic GVHD: Forced Expiratory Volume in one second (FEV-1). Single breath diffusing capacity (DLCO) adjusted.

FEV-1 FEV-1 is the volume exhaled during the first second of a forced expiratory maneuver that is started from the level of total lung capacity. It is the most frequently used index for assessing airway obstruction, bronchoconstriction, or bronchodilatation.

Single-Breath DLCO Adjusted The single breath diffusing capacity, or DLCO, is a measure of the ability of the lungs to diffuse oxygen into, and carbon dioxide from, the bloodstream. Since DLCO may be decreased when the patient is anemic, the DLCO value corrected for anemia is the one that should be reported.