Incidence, outcome, and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation
- 2 February 2004
- journal article
- Published by Springer Science and Business Media LLC in Bone Marrow Transplantation
- Vol. 33 (7), 751-758
- https://doi.org/10.1038/sj.bmt.1704426
Abstract
We evaluated the incidence, the risk factors, and the outcome of late-onset noninfectious pulmonary complications (LONIPCs) among 50 patients who underwent allogeneic stem cell transplantation from unrelated donors. Of the 39 patients surviving at least 3 months, 10 (26%) fulfilled the diagnostic criteria of LONIPCs and were further subclassified as having bronchiolitis obliterans (four patients), bronchiolitis obliterans with organizing pneumonia (four patients), and interstitial pneumonia (two patients). Two patients had a durable partial remission after treatment with prednisone and cyclosporine; the remaining eight patients did not respond to treatment and five of them died of respiratory failure. Advanced stage of disease at transplant and chronic extensive graft-versus-host disease (GVHD) were significantly associated with the development of LONIPCs. Pulmonary function test (PFT) results before transplantation were similar in all patients, but patients with LONIPCs had a significant decrease in PFT indexes at the third month after BMT compared with controls. Moreover, the rate of cyclosporine taper during the fourth and fifth months after BMT was significantly more rapid in patients with LONIPCs than in controls, suggesting that the risk of LONIPCs may be influenced by a faster reduction of GVHD prophylaxis.Keywords
This publication has 26 references indexed in Scilit:
- Late-onset noninfectious pulmonary complications after allogeneic stem cell transplantation are significantly associated with chronic graft-versus-host disease and with the graft-versus-leukemia effectBlood, 2003
- Higher doses of CD34+ peripheral blood stem cells are associated with increased mortality from chronic graft-versus-host disease after allogeneic HLA-identical sibling transplantationLeukemia, 2003
- Progressive interstitial fibrosis of the lung in sclerodermoid chronic graft-versus-host diseaseBone Marrow Transplantation, 2002
- Management of graft-versus-host diseaseBlood Reviews, 2000
- Non-infectious lung complications are closely associated with chronic graft-versus-host disease: a single center study of incidence, risk factors and outcomeBone Marrow Transplantation, 2000
- Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamideEuropean Respiratory Journal, 1995
- Clinical and Histologic Spectrum of Bronchiolitis Obliterans, Including Bronchiolitis Obliterans Organizing PneumoniaSeminars in Respiratory and Critical Care Medicine, 1992
- LONG-TERM CYCLOSPORIN THERAPY MAY DECREASE THE RISK OF CHRONIC GRAFT-VERSUS-HOST DISEASEBritish Journal of Haematology, 1990
- Antileukemic Effect of Graft-versus-Host Disease in Human Recipients of Allogeneic-Marrow GraftsNew England Journal of Medicine, 1979
- CLINICAL MANIFESTATIONS OF GRAFT-VERSUS-HOST DISEASE IN HUMAN RECIPIENTS OF MARROW FROM HL-A-MATCHED SIBLING DONOR,STransplantation, 1974