Therapeutic effect of budesonide/formoterol, montelukast and N-acetylcysteine for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation

被引：22
作者：
Kim, Sei Won [1 ]
Rhee, Chin Kook [1 ]
Kim, Yoo Jin [2 ]
Lee, Seok [2 ]
Kim, Hee Je [2 ]
Lee, Jong Wook [2 ]
机构：
[1] Catholic Univ Korea, Dept Internal Med, Coll Med, Div Pulm Allergy & Crit Care Med, Seoul, South Korea
[2] Catholic Univ Korea, Div Hematol, Dept Internal Med, Coll Med, Seoul, South Korea
来源：
RESPIRATORY RESEARCH | 2016年 / 17卷
关键词：
Bronchiolitis obliterans syndrome; Inhaled corticosteroid; Long-acting beta(2)-adrenergic agonist; Montelukast; n-acetylcysteine; OBSTRUCTIVE PULMONARY-DISEASE; VERSUS-HOST-DISEASE; CLINICALLY IMPORTANT DIFFERENCE; PLACEBO-CONTROLLED TRIAL; GAS-EXPOSED PATIENTS; COPD ASSESSMENT TEST; LUNG TRANSPLANTATION; INHALED CORTICOSTEROIDS; ASTHMA; INTERLEUKIN-8;
D O I：
10.1186/s12931-016-0380-1
中图分类号：
R56 [呼吸系及胸部疾病];
学科分类号：
摘要：
Background: Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (HSCT) is currently treated with systemic corticosteroids despite poor efficacy and side effects. This study investigated the therapeutic effect of budesonide/formoterol, montelukast and n-acetylcysteine, which are suggested as treatment options for BOS after HSCT. Methods: After diagnosis of BOS, 61 patients were treated with budesonide/formoterol, montelukast and n-acetylcysteine for 3 months. Pulmonary function test and COPD assessment test (CAT) were performed before and after the combination therapy. Therapeutic response was evaluated by changes in forced expiratory volume in 1 s (FEV1) or CAT score. Results: After 3 months of combination treatment, mean FEV1 increased by 220 mL (p < 0.001) and residual volume decreased by 200 mL (p = 0.005). Median CAT score also significantly decreased from 15.5 to 11.0 (p = 0.001). The overall response rate to combination therapy was 82 %. Comparing the no-response group and the response group, the forced vital capacity (% predicted) decline between pre-HSCT and BOS diagnosis was significantly greater in the response group (p = 0.036). Conclusion: Combination treatment with budesonide/formoterol, montelukast and n-acetylcysteine significantly improved lung function and respiratory symptoms in patients with BOS after allogeneic HSCT without serious side effects.
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页数：9
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