Bronchiolitis obliterans organizing pneumonia (BOOP) with suspected liver graft-versus-host disease after allogeneic bone marrow transplantation

Abstract

We report on a patient with chronic myelogenous leukemia who developed bronchiolitis obliterans organizing pneumonia (BOOP) after allogeneic bone marrow transplantation (BMT). A 19-year-old Japanese male complained of dry cough and dyspnea 7 months after BMT. The chest X-ray and computed tomography revealed patchy infiltrates bilaterally. Lung function test, lung biopsy and bronchoalveolar lavage were consistent with the diagnosis of BOOP. The patient also suffered from suspected graft-versus-host disease (GVHD) of the liver, after discontinuation of cyclosporine. Furthermore, prednisolone proved effective against the BOOP and the liver dysfunction. These findings indicate that BOOP is a possible pulmonary manifestation of chronic GVHD, and that immunological mechanisms may have effected the onset of BOOP after BMT in this case.

Nodular pulmonary lesions in children after autologous stem cell transplantation: a source of misinterpretation

“…BO and BOOP occur therefore predominantly in allogeneic HSCT, where they harbour 61% and 21% mortality rates respectively (Afessa et al , 2001). Most cases of BOOP have been described in adults after allogeneic HSCT (Cazzato et al , 2000; Kanamori et al , 2001) and there are only a few reports on paediatric patients with this disease (Mathew et al , 1994; Hayes‐Jordan et al , 2002). However, post‐transplant‐BOOP in children may be an under‐recognized respiratory complication (Mathew et al , 1994).…”