Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT

K. Ueda, T. Watadani, E. Maeda, S. Ota, K. Kataoka, S. Seo, K. Kumano, A. Hangaishi, T. Takahashi, Y. Imai, K. Ohtomo, M. Fukayama, Y. Nannya, M. Kurokawa

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

Abstract

Late-onset noninfectious pulmonary complications (LONIPCs) are life threatening for allogeneic hematopoietic SCT (allo-HSCT) recipients. However, the impact of LONIPCs on survival has not been properly evaluated and little is known about treatment efficacy. We retrospectively investigated 290 allo-HSCT recipients in our institute and reviewed the clinical aspects of 44 patients who had been diagnosed with LONIPCs. LONIPCs were significantly associated with higher rates of chronic GVHD (P<0001) and nonrelapse mortality (P = 0.013), and lower rates of relapse (P = 0.009). As a result of these effects, OS was significantly worse in those with LONIPCs (P = 0.003). This result differs from a previous report. We then assessed short-term treatment response and final outcome. These results were defined by radiological findings, subjective symptoms, oxygen requirement and survival. Use of inhaled and systemic steroids did not affect either short-term response or final outcomes. However, administration of systemic corticosteroids earlier than at 21 days (median interval of time from onset of symptoms to systemic corticosteroids administration) was associated with a better outcome (P = 0.054 for short-term response, and 0.016 for final outcome). Our study indicates that LONIPCs reduce OS, and early intervention with systemic corticosteroids may be effective.

Original languageEnglish
Pages (from-to)1719-1727
Number of pages9
JournalBone Marrow Transplantation
Volume45
Issue number12
DOIs
Publication statusPublished - 2010 Dec
Externally publishedYes

Keywords

  • GVHD
  • SCT
  • corticosteroids
  • pulmonary complication
  • survival analysis

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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