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

Chiaki Nakaseko, Shinichi Ozawa, Emiko Sakaida, Miwa Sakai, Yoshinobu Kanda, Kumi Oshima, Mineo Kurokawa, Satoshi Takahashi, Jun Ooi, Takayuki Shimizu, Akira Yokota, Fumiaki Yoshiba, Katsumichi Fujimaki, Heiwa Kanamori, Rika Sakai, Takayuki Saitoh, Tohru Sakura, Atsuo Maruta, Hisashi Sakamaki, Shinichiro Okamoto

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)375-382
Number of pages8
JournalInternational journal of hematology
Volume93
Issue number3
DOIs
Publication statusPublished - 2011 Mar 1

Keywords

  • Bronchiolitis obliterans
  • Chronic GVHD
  • Late onset non-infectious pulmonary complications
  • PBSC

ASJC Scopus subject areas

  • Hematology

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    Nakaseko, C., Ozawa, S., Sakaida, E., Sakai, M., Kanda, Y., Oshima, K., Kurokawa, M., Takahashi, S., Ooi, J., Shimizu, T., Yokota, A., Yoshiba, F., Fujimaki, K., Kanamori, H., Sakai, R., Saitoh, T., Sakura, T., Maruta, A., Sakamaki, H., & Okamoto, S. (2011). Incidence, risk factors and outcomes of bronchiolitis obliterans after allogeneic stem cell transplantation. International journal of hematology, 93(3), 375-382. https://doi.org/10.1007/s12185-011-0809-8