A case-control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation

Hideki Nakasone, Junya Kanda, Shingo Yano, Yoshiko Atsuta, Hiroatsu Ago, Takahiro Fukuda, Kazuhiko Kakihana, Tatsuya Adachi, Toshiaki Yujiri, Shuichi Taniguchi, Jun Taguchi, Yasuo Morishima, Tokiko Nagamura, Hisashi Sakamaki, Takehiko Mori, Makoto Murata

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Abstract

Bronchiolitis obliterans syndrome (BOS) is a significant complication after allogeneic hematopoietic stem cell transplantation (HSCT). However, the pathogenesis and risks for the development of BOS have remained unclear. Therefore, a case-control study was conducted to investigate the risk factors for the development of BOS, which included the largest number of BOS cases; 196 patients with BOS were identified and compared with 1960 control recipients. The following were identified as significantly higher risk factors for the development of BOS: female recipients (OR 1.47, P = 0.019), ABO-mismatch HSCT (minor mismatch, OR 1.67, P = 0.015; major mismatch, OR 1.73, P = 0.012; bidirectional mismatch, OR 1.96, P = 0.018), busulfan+cyclophosphamide-based myeloablative conditioning (OR 1.74, P = 0.016), and acute graft-versus-host disease (GVHD) involving the skin (OR 1.55, P = 0.011). On the other hand, the risk for the development of BOS was significantly lower in patients receiving cord blood transplantation (OR 0.26, P = 0.0011). With respect to other target organs of chronic GVHD, ocular involvement was significantly associated with BOS (OR 2.53, P < 0.001). Prospective studies are required to elucidate the risk factors for the development of BOS, and future investigations should focus on finding a prophylactic approach against BOS based on these findings.

Original languageEnglish
Pages (from-to)631-639
Number of pages9
JournalTransplant International
Volume26
Issue number6
DOIs
Publication statusPublished - 2013 Jun

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Keywords

  • ABO-mismatch
  • allogeneic hematopoietic stem cell transplantation
  • bronchiolitis obliterans syndrome
  • cord blood
  • graft-versus-host disease

ASJC Scopus subject areas

  • Transplantation

Cite this

Nakasone, H., Kanda, J., Yano, S., Atsuta, Y., Ago, H., Fukuda, T., Kakihana, K., Adachi, T., Yujiri, T., Taniguchi, S., Taguchi, J., Morishima, Y., Nagamura, T., Sakamaki, H., Mori, T., & Murata, M. (2013). A case-control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation. Transplant International, 26(6), 631-639. https://doi.org/10.1111/tri.12093