Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

被引：37
|
作者：
Uhlving, H. H. [1 ,2 ]
Buchvald, F. [1 ,3 ]
Heilmann, C. J. [1 ]
Nielsen, K. G. [1 ,3 ]
Gormsen, M. [4 ]
Muller, K. G. [1 ,2 ]
机构：
[1] Rigshosp, Natl Univ Hosp, Paediat Clin, DK-2100 Copenhagen OE, Denmark
[2] Rigshosp, Natl Univ Hosp, Dept Rheumatol, Inst Inflammat Res, DK-2100 Copenhagen OE, Denmark
[3] Rigshosp, Natl Univ Hosp, Paediat Pulm Serv, DK-2100 Copenhagen OE, Denmark
[4] Rigshosp, Natl Univ Hosp, Dept Radiol, DK-2100 Copenhagen OE, Denmark
来源：
BONE MARROW TRANSPLANTATION | 2012年 / 47卷 / 08期
关键词：
bronchiolitis obliterans; allogeneic haematopoietic SCT; chronic graft-versus-host disease; treatment outcome; methylprednisolone; VERSUS-HOST-DISEASE; STEM-CELL TRANSPLANTATION; BONE-MARROW-TRANSPLANTATION; NONINFECTIOUS PULMONARY COMPLICATIONS; CONSENSUS DEVELOPMENT PROJECT; OBSTRUCTIVE LUNG-DISEASE; IDIOPATHIC PNEUMONIA SYNDROME; RECEPTOR FUSION PROTEIN; AIR-FLOW OBSTRUCTION; EXTRACORPOREAL PHOTOPHERESIS;
D O I：
10.1038/bmt.2011.161
中图分类号：
Q6 [生物物理学];
学科分类号：
071011 ;
摘要：
Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology and pathogenesis is still limited. Diagnostic criteria are being developed, and will allow more uniform and comparable research activities between centres. At present, no randomised controlled trials have been completed that could demonstrate an effective treatment. Steroids in combination with other immunosuppressive drugs still constitute the backbone of the treatment strategy, and results from our and other centres suggest that monthly infusions of high-dose pulse i.v. methylprednisolone (HDPM) might stabilise the disease and hinder progression. This article provides an overview of the current evidence regarding treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort. Bone Marrow Transplantation (2012) 47, 1020-1029; doi:10.1038/bmt.2011.161; published online 29 August 2011
引用
收藏
页码：1020 / 1029
页数：10
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