Risk Factors for Bronchiolitis Obliterans in Allogeneic Hematopoietic Stem-Cell Transplantation for Leukemia

Tomas, Linus H. Santo; Loberiza, Fausto R.; Klein, John P.; Layde, Peter M.; Lipchik, Randolph J.; Rizzo, J. Douglas; Bredeson, Christopher; Horowitz, Mary M.

doi:10.1378/chest.128.1.153

Cited by 155 publications

(147 citation statements)

References 47 publications

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“…These findings are compatible with previous reports. 9,12,[17][18][19] On the other hand, reduced-intensity conditioning 35 and use of alemtuzumab did not reduce LONIPCs in our study, which was not compatible with previous reports.…”

Section: Discussioncontrasting

confidence: 99%

“…These facts limited the standardization of Palmas's criteria and individual reports of LONIPCs use different classification criteria. 8,9,12 Recently, several studies have revealed many risk factors that are associated with the onset of LONIPCs, including cGVHD, 9,[12][13][14][15][16][17][18][19] donor and recipient age, 13 baseline pulmonary function, 13 use of TBI, 20 and so on. There is a general agreement that cGVHD is the most strongly associated risk factor.…”

Section: Introductionmentioning

confidence: 99%

“…There is a general agreement that cGVHD is the most strongly associated risk factor. 9,[12][13][14][15][16][17][18][19] Although patients with LONIPCs have high nonrelapse mortality (NRM) rates, 9,12 they experience low relapse rates of the underlying disease presumably because high concomitant rates of cGVHD exert a graft-vs-tumor effect. 9 Thus, it remains unknown whether the onset of LONIPCs has an impact on OS or relapse-free survival as a consequence of these contradictory factors.…”

Section: Introductionmentioning

confidence: 99%

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Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT

Ueda

Watadani

Maeda

et al. 2010

Bone Marrow Transplant

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Late-onset noninfectious pulmonary complications (LONIPCs) are life threatening for allogeneic hematopoietic SCT (allo-HSCT) recipients. However, the impact of LONIPCs on survival has not been properly evaluated and little is known about treatment efficacy. We retrospectively investigated 290 allo-HSCT recipients in our institute and reviewed the clinical aspects of 44 patients who had been diagnosed with LONIPCs. LONIPCs were significantly associated with higher rates of chronic GVHD (Po0001) and nonrelapse mortality (P ¼ 0.013), and lower rates of relapse (P ¼ 0.009). As a result of these effects, OS was significantly worse in those with LONIPCs (P ¼ 0.003). This result differs from a previous report. We then assessed short-term treatment response and final outcome. These results were defined by radiological findings, subjective symptoms, oxygen requirement and survival. Use of inhaled and systemic steroids did not affect either short-term response or final outcomes. However, administration of systemic corticosteroids earlier than at 21 days (median interval of time from onset of symptoms to systemic corticosteroids administration) was associated with a better outcome (P ¼ 0.054 for short-term response, and 0.016 for final outcome). Our study indicates that LONIPCs reduce OS, and early intervention with systemic corticosteroids may be effective.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT

Ueda

Watadani

Maeda

et al. 2010

Bone Marrow Transplant

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“…8,9 The association with CY þ TBIbased MAC is a critically important difference between COP/BOOP and bronchiolitis obliterans syndrome, as BU-based conditioning, rather than TBI-based conditioning, has been reported to be associated with bronchiolitis obliterans syndrome. 25,26 Third, GVHD was associated with COP/BOOP as seen in previous reports. 8 Especially, COP/BOOP was significantly associated with the presence of skin involvement of both aGVHD and cGVHD, although the association with GVHD was analyzed separately.…”

Section: Discussionsupporting

confidence: 64%

Pre-transplant risk factors for cryptogenic organizing pneumonia/bronchiolitis obliterans organizing pneumonia after hematopoietic cell transplantation

Nakasone

Onizuka

Suzuki

et al. 2013

Bone Marrow Transplant

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Cryptogenic organizing pneumonia (COP), previously known as bronchiolitis obliterans organizing pneumonia (BOOP), is a significant complication after allogeneic hematopoietic SCT (HCT). However, the pathogenesis of this complication has not yet been elucidated. Therefore, we identified the pre-transplant risk factors for the development of COP/BOOP using the Japan transplant registry database between 2005 and 2009. Among 9550 eligible recipients, 193 experienced COP/BOOP (2%). HLA disparity (odds ratio (OR) 1.51, P ¼ 0.05), female-to-male HCT (OR 1.53, P ¼ 0.023), and PBSC transplant (OR 1.84, P ¼ 0.0076) were significantly associated with an increased risk of COP/BOOP. On the other hand, BU-based myeloablative conditioning (OR 0.52, P ¼ 0.033), or fludarabine-based reduced-intensity conditioning (OR 0.50, P ¼ 0.0011) in comparison with a TBI-based regimen and in vivo T-cell depletion (OR 0.46, P ¼ 0.055) were associated with a lower risk. Of the 193 patients with COP/BOOP, 77 died, including non-relapse death in 46 (59%). Pulmonary failure and fatal infection accounted for 41% (n ¼ 19) and 26% (n ¼ 12) of the non-relapse death. Allogeneic immunity and conditioning toxicity could be associated with COP/BOOP. Prospective studies are required to elucidate the true risk factors for COP/BOOP and to develop a prophylactic approach.

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“…8,9 The incidence of LONIPCs is 10-25% and they are closely associated with TRM. 8,10,11 The pathogenesis of LONIPCs has not been elucidated, but their development is consistently associated with the presence of chronic GVHD, [10][11][12][13][14][15][16] indicating that allo-immune reactions play a major role in the development of LONIPCs.…”

Section: Introductionmentioning

confidence: 99%

Late-onset non-infectious pulmonary complications following allogeneic hematopoietic stem cell transplantation in children

Nishio

Yagasaki

Takahashi

et al. 2009

Bone Marrow Transplant

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Risk Factors for Bronchiolitis Obliterans in Allogeneic Hematopoietic Stem-Cell Transplantation for Leukemia

Cited by 155 publications

References 47 publications

Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT

Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT

Pre-transplant risk factors for cryptogenic organizing pneumonia/bronchiolitis obliterans organizing pneumonia after hematopoietic cell transplantation

Late-onset non-infectious pulmonary complications following allogeneic hematopoietic stem cell transplantation in children

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