Incidence, risk factors and outcomes of bronchiolitis obliterans after allogeneic stem cell transplantation

被引：49

作者：

Nakaseko, Chiaki ^{[1
]}

Ozawa, Shinichi ^{[1
]}

Sakaida, Emiko ^{[1
]}

Sakai, Miwa ^{[2
]}

Kanda, Yoshinobu ^{[3
]}

Oshima, Kumi ^{[3
]}

Kurokawa, Mineo

Takahashi, Satoshi ^{[4
]}

Ooi, Jun ^{[4
]}

Shimizu, Takayuki ^{[5
]}

Yokota, Akira ^{[7
]}

Yoshiba, Fumiaki ^{[6
,8
]}

Fujimaki, Katsumichi ^{[9
]}

Kanamori, Heiwa ^{[10
]}

Sakai, Rika ^{[10
,11
]}

Saitoh, Takayuki ^{[12
]}

Sakura, Tohru ^{[13
]}

Maruta, Atsuo ^{[10
]}

Sakamaki, Hisashi ^{[2
]}

Okamoto, Shinichiro ^{[5
]}

机构：

[1] Chiba Univ, Dept Hematol, Grad Sch Med, Chuo Ku, Chiba 2608670, Japan

[2] Tokyo Metropolitan Komagome Hosp, Dept Hematol, Tokyo, Japan

[3] Jichi Med Univ, Div Hematol, Saitama Med Ctr, Saitama, Japan

[4] Univ Tokyo, Dept Hematol & Oncol, Inst Med Sci, Tokyo, Japan

[5] Keio Univ, Sch Med, Dept Med, Div Hematol, Tokyo 160, Japan

[6] Tokai Univ, Sch Med, Dept Med, Div Hematol & Oncol, Isehara, Kanagawa 25911, Japan

[7] Chiba Aoba Municipal Hosp, Dept Internal Med, Chiba, Japan

[8] Tokai Univ, Sch Med, Div Hematol & Oncol, Dept Med, Isehara, Kanagawa 25911, Japan

[9] Yokohama City Univ, Dept Internal Med & Clin Immunol, Grad Sch Med, Yokohama, Kanagawa 232, Japan

[10] Kanagawa Canc Ctr, Dept Hematol, Yokohama, Kanagawa 2410815, Japan

[11] Yokohama City Univ, Dept Hematol, Med Ctr, Yokohama, Kanagawa 232, Japan

[12] Gunma Univ, Dept Med & Clin Sci, Grad Sch Med, Maebashi, Gunma 371, Japan

[13] Saiseikai Maebashi Hosp, Div Hematol, Maebashi, Gunma, Japan

来源：

INTERNATIONAL JOURNAL OF HEMATOLOGY | 2011年 / 93卷 / 03期

关键词：

Bronchiolitis obliterans; Chronic GVHD; Late onset non-infectious pulmonary complications; PBSC; NONINFECTIOUS PULMONARY COMPLICATIONS; VERSUS-HOST-DISEASE; OBSTRUCTIVE LUNG-DISEASE; AIR-FLOW OBSTRUCTION; CHRONIC GRAFT; MARROW TRANSPLANTATION; DIAGNOSIS;

D O I：

10.1007/s12185-011-0809-8

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Bronchiolitis obliterans (BO) after allogeneic stem cell transplantation (allo-SCT) is a late-onset, life-threatening respiratory complication that significantly reduces a patient's quality of life. We retrospectively analysed the incidence of and risk factors for BO in allo-SCT recipients. In 2087 patients who underwent allo-SCT between January 1994 and June 2005 and survived > 90 days after transplantation, 57 patients developed BO with a 5-year cumulative incidence of 2.8%. The median time interval from transplantation to BO diagnosis was 335 days (range 83-907 days). The 5-year cumulative incidence of BO was 1.62% in bone marrow transplantation (BMT) from related donors, 3.83% in peripheral blood stem cell transplantation (PBSCT) from related donors (R-PBSCT), 2.91% in BMT from unrelated donors and 2.65% in unrelated cord blood transplantation. The incidence of BO after R-PBSCT was significantly higher than that after any other type of allo-SCT (p = 0.02). R-PBSCT (p = 0.019) and preceding chronic graft-versus-host disease (GVHD) (p < 0.001) were BO-associated risk factors. Overall 5-year survival of patients with BO from the time of diagnosis was 45.4%, significantly less than those without (77.5% from day 335, p < 0.001). R-PBSCT recipients with existent chronic GVHD have a high risk of developing BO, and need extensive care and repeated pulmonary function tests.

引用

页码：375 / 382

页数：8

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