Pulmonary complications following hematopoietic stem cell transplantation: Diagnostic approaches

Sirithanakul, Kasem; Salloum, Anan; Klein, Jared; Soubani, Ayman O.

doi:10.1002/ajh.20437

Cited by 28 publications

(23 citation statements)

References 87 publications

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“…Pulmonary complications, both infectious and noninfectious, occur in 25 to 50% of stem cell transplant (SCT) recipients and are associated with significant morbidity and mortality. 19,[189][190][191][192][193] Myriad noninfectious pulmonary complications of HSCT include the different subsets of idiopathic pneumonia syndrome (IPS) [eg, acute pulmonary hemorrhage or hemorrhagic alveolitis/diffuse alveolar hemorrhage (DAH), periengraftment respiratory distress syndrome (PERDS), delayed pulmonary toxicity syndrome (DPTS), and acute GVHD of the lung], posttransplant lymphoproliferative disease (PTLD), eosinophilic pneumonia (EP), pulmonary alveolar proteinosis (PAP), pulmonary veno-occlusive disease (PVOD), pulmonary cytolytic thrombi (PCT), transfusion-related acute lung injury (TRALI), pulmonary thromboemboli; and bronchiolar disorders (both OP and OB/BOS). 10,19,24,194,195 This review limits the discussion to OB/BOS.…”

Section: Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Obliterative (Constrictive) Bronchiolitis

Lynch

Weigt

Derhovanessian

et al. 2012

Semin Respir Crit Care Med

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Obliterative bronchiolitis (OB) (formerly termed bronchiolitis obliterans), is a rare fibrotic disorder involving terminal and respiratory bronchioles. The term constrictive bronchiolitis is synonymous with OB. Clinically, OB is characterized by progressive (often fatal) airflow obstruction, the absence of parenchymal infiltrates on chest radiographs, a mosaic pattern of perfusion on high-resolution computed tomographic scan, poor responsiveness to therapy, and high mortality rates. Most cases of OB occur in the context of a specific risk factor. Currently, most cases of OB occur in lung transplant recipients with chronic allograft rejection or hematopoietic stem cell transplant (HSCT) recipients with graft versus host disease (GVHD). Other causes of OB include connective tissue disease (CTD) (particularly rheumatoid arthritis); lower respiratory tract infections; inhalation injury; exposure or inhalation of toxic fumes, metals, dusts, particulate matter, or pollutants; occupational exposures; drug reactions; consumption of uncooked leaves of Sauropus androgynus; chronic hypersensitivity pneumonia; diffuse neuroendocrine cell hyperplasia; miscellaneous. When no cause is identified, the term cryptogenic obliterative bronchiolitis is used. This review discusses the salient clinical, radiographic, and histological features of OB and presents a management approach.

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Section: Hematopoietic Stem Cell Transplantationmentioning

confidence: 99%

Obliterative (Constrictive) Bronchiolitis

Lynch

Weigt

Derhovanessian

et al. 2012

Semin Respir Crit Care Med

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“…Pulmonary complications, both infectious and non‐infectious, occur in 25–50% of HSCT recipients and are associated with significant morbidity and mortality (1–6). The advances in the diagnosis and management of infectious pulmonary complications following HSCT have increased the significance of non‐infectious complications.…”

Section: Summary Of the Findings Of The Main Studies Describing Bo Fmentioning

confidence: 99%

Bronchiolitis obliterans following hematopoietic stem cell transplantation: a clinical update

Pandya

Soubani

2010

Clinical Transplantation

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Hematopoietic stem cell transplantation (HSCT) is an established treatment for a variety of malignant and non-malignant conditions. Pulmonary complications, infectious and non-infectious, are a major cause of morbidity and mortality in these patients. The recent advances in prophylaxis and treatment of infectious complications increased the significance of late non-infectious pulmonary conditions. Currently, bronchiolitis obliterans is one of the most challenging pulmonary complications facing clinicians who are taking care of HSCT recipients. This report provides a clinical update of the incidence, risk factors, pathogenesis, clinical characteristics, and management of bronchiolitis obliterans following HSCT.

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“…However, commonly, this procedure is limited by the relatively high surgical morbidity and mortality in this patient population. 5 …”

Section: Pulmonary Alveolar Proteinosismentioning

confidence: 99%

“…Chronic myeloid leukemia in the chronic phase is associated with a low risk of early invasive pulmonary aspergillosis (IPA) compared with other hematologic malignancies, aplastic anemia, and myelodysplastic syndrome. 5 Knowing the time since transplant is essential, major pulmonary complications after HSCT occur in a relatively well-defined timeline after the transplant. The usual time course after transplant is divided into the preengraftment phase (< 30 d), the immediate postengraftment phase (30 to 100 d), or the late postengraftment phase (after 100 d).…”

mentioning

confidence: 99%

Pulmonary Complications After Hematopoietic Stem Cell Transplantation

ZazaDitYafawi

Soubani²

2015

Clinical Pulmonary Medicine

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Hematopoietic stem cell transplantation (HSCT) is a therapeutic modality for several benign and malignant disorders; however, it is still limited by the development of serious complications. Pulmonary complications are common after both autologous and allogeneic HSCTs with a wide range of infectious and noninfectious disorders. Advances in the prophylaxis and the treatment of infectious pulmonary complications have decreased their incidence although they continue to be an important cause of morbidity and mortality. In contrast, the frequency of noninfectious pulmonary complications associated with HSCT remains unchanged. It is important for the clinician caring for HSCT patients to be familiar with the pulmonary manifestations after HSCT. This report provides an updated review on the pulmonary complications after HSCT, including their incidence, clinical presentation, diagnosis, and management. It also provides an overview of the diagnostic approach to these complications. (Clin Pulm Med 2015;22:230-238) H ematopoietic stem cell transplant (HSCT) is increasingly being used for the treatment of a wide range of benign and malignant diseases. About 50,000 to 60,000 HSCTs are being performed annually. 1 HSCT can be classified as autologous when the stem cells are harvested from the same patient and reinfused after high-dose chemotherapy, whereas in allogeneic HSCT, the stem cells are donated by another person. Allogeneic HSCT can be related or unrelated and matched or mismatched. The hematopoietic stem cells might be derived from the bone marrow, the umbilical cord, or the peripheral blood.HSCT can be a life-saving treatment for a wide range of diseases; however, it is still limited by the development of serious complications. Advances in the preparative regimen using a nonmyeloablative preparative regimen and reduced intensity conditioning transplants (RIT) and posttransplant supportive care have contributed to an improved overall survival. Despite these advances, pulmonary complications still occur in about 37% of the patients after HSCT 2 and are associated with significant morbidity and mortality. In 1 study, the hazard ratio for death due to the pulmonary complications was 30. 1 This article reviews the different pulmonary complications, both infectious and noninfectious, after HSCT, and provides an updated review of the diagnostic approach and the management of these complications.The approach to the diagnosis of pulmonary complications after HSCT should take into consideration the risk factors such as the type of conditioning regimen. Compared with a nonmyeloablative regimen (RIT), the myeloablative regimen is associated with pulmonary complications more frequently, with a higher risk of bacterial infections early after HSCT. 3

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Pulmonary complications following hematopoietic stem cell transplantation: Diagnostic approaches

Cited by 28 publications

References 87 publications

Obliterative (Constrictive) Bronchiolitis

Obliterative (Constrictive) Bronchiolitis

Bronchiolitis obliterans following hematopoietic stem cell transplantation: a clinical update

Pulmonary Complications After Hematopoietic Stem Cell Transplantation

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