Bronchiolitis obliterans following pediatric allogeneic hematopoietic stem cell transplantation

Duncan, C. N.; Buonanno, M. R.; Barry, E. V.; Myers, K.; Peritz, D.; Lehmann, L.
June 2008
Bone Marrow Transplantation;Jun2008, Vol. 41 Issue 11, p971
Academic Journal
Bronchiolitis obliterans (BrOb) is a well-recognized complication of allogeneic hematopoietic stem cell transplantation (HSCT). It is associated with substantial morbidity and mortality in adult patients. However, the incidence and morbidity of this complication have not been well described in the pediatric population. We report our experience of BrOb in 216 pediatric allogeneic HSCT patients between 1 January 2001 and 31 December 2005. In total 18 of 216 patients developed BrOb during this time. The diagnosis of BrOb was based on pulmonary function abnormalities, radiographic findings or lung biopsy. In total 14 of 18 patients with BrOb received stem cells from unrelated donors. In total 17 of 18 patients received bone marrow as a stem cell source, and 1 received peripheral blood stem cells. All pediatric patients in this report had a known risk factor for BrOb, most commonly chronic GVHD (l8 of 18 patients). Additionally, 7 of 18 patients had either toxic lung injury or virally mediated pulmonary disease before the diagnosis of BrOb. With a median of 45.1 months of follow-up, the outcomes were 5 of 18 patients died of lung disease, 2 died of other causes, 3 had progressive lung disease, 6 achieved partial resolution of disease and 2 had stable disease. BrOb, while uncommon, is associated with considerable morbidity and mortality in pediatric HSCT.Bone Marrow Transplantation (2008) 41, 971�975; doi:10.1038/bmt.2008.19; published online 25 February 2008


Related Articles

  • Reduced respiratory and skeletal muscle strength in survivors of sibling or unrelated donor hematopoietic stem cell transplantation. Kovalszki, A.; Schumaker, G. L.; Klein, A.; Terrin, N.; White, A. C. // Bone Marrow Transplantation;Jun2008, Vol. 41 Issue 11, p965 

    We performed a retrospective analysis of muscle strength testing obtained following sibling or unrelated donor hematopoietic stem cell transplant (HSCT) between 1 January 1999 and 31 December 2003 in a cohort of 44 subjects at Tufts-New England Medical Center. Maximal inspiratory pressure...

  • Alternative donor transplants for adult acute lymphoblastic leukaemia: a comparison of the three major options. Marks, D. I.; Aversa, F.; Lazarus, H. M. // Bone Marrow Transplantation;Oct2006, Vol. 38 Issue 7, p467 

    Myeloablative sibling-matched allogeneic transplantation for adult acute lymphoblastic leukaemia provides the best outcome, but most patients lack a suitable, related histocompatible donor. We reviewed three haematopoietic stem cell donor sources used for alternative donor transplantation...

  • Inhaled corticosteroids stabilize constrictive bronchiolitis after hematopoietic stem cell transplantation. Bashoura, L.; Gupta, S.; Jain, A.; Couriel, D. R.; Komanduri, K. V.; Eapen, G. A.; Safdar, A.; Broglio, K. R.; Adachi, R.; Dickey, B. F. // Bone Marrow Transplantation;Jan2008, Vol. 41 Issue 1, p63 

    Post transplantation constrictive bronchiolitis (PTCB) is the most common pulmonary complication among long-term survivors of allogeneic hematopoietic stem cell transplantation (HSCT). It is a late manifestation of GVHD. Its treatment with high-dose systemic corticosteroids and other...

  • GASTROINTESTINAL SYMPTOMS AND GROWTH PATTERNS IN CHILDREN POST BONE MARROW TRANSPLANT. Rodgers, Cheryl; Wills-Alcoser, Patricia; Monroe, Rebecca; McDonald, Lisa; Trevino, Melisa; Hockenberry, Marilyn // Oncology Nursing Forum;Mar2007, Vol. 34 Issue 2, p530 

    Children are at risk for long-term malnutrition after a bone marrow transplant (BMT) due to poor oral intake, altered absorption and increased metabolic demands as a result of medical complications and/or medication toxicities. Despite these known risks, little research has been performed to...

  • Reliability of a pretransplant i.v. BU test dose performed 2 weeks before myeloablative FluBu conditioning regimen. Beri, R.; Chunduri, S.; Sweiss, K.; Peace, D. J.; Mactal-Haaf, C.; Dobogai, L. C.; Shord, S.; Quigley, J. G.; Chen, Y. H.; Mahmud, N.; Rondelli, D. // Bone Marrow Transplantation;Feb2010, Vol. 45 Issue 2, p249 

    A pretransplant test dose of i.v. BU was previously used in pediatric patients undergoing a reduced-intensity allogeneic hematopoietic SCT (HSCT). Here, we used a BU test dose in 23 adult patients who were not pancytopenic and underwent a myeloablative allogeneic HSCT prepared with fludarabine...

  • Protective Conditioning for Acute Graft-versus-Host Disease. Lowsky, Robert; Takahashi, Tsuyoshi; Liu, Yin Ping; Dejbakhsh-Jones, Sussan; Grumet, F. Carl; Shizuru, Judith A.; Laport, Ginna G.; Stockerl-Goldstein, Keith E.; Johnston, Laura J.; Hoppe, Richard T.; Bloch, Daniel A.; Blume, Karl G.; Negrin, Robert S.; Strober, Samuel // New England Journal of Medicine;9/29/2005, Vol. 353 Issue 13, p1321 

    Background: Conditioning with total lymphoid irradiation plus antithymocyte serum protects mice against acute graft-versus-host disease (GVHD) after hematopoietic-cell transplantation. We tested this strategy in humans. Methods: Thirty-seven patients with lymphoid malignant diseases or acute...

  • Safety and outcome after fludarabine-thiotepa-TBI conditioning for allogeneic transplantation: a prospective study of 30 patients with hematologic malignancies. van Besien, K; Devine, S; Wickrema, A; Jessop, E; Amin, K; Yassine, M; Maynard, V; Stock, W; Peace, D; Ravandi, F; Chen, Y-H; Cheung, T; Vijayakumar, S; Hoffman, R; Sosman, J // Bone Marrow Transplantation;Jul2003, Vol. 32 Issue 1, p9 

    Summary:Fludarabine, thiotepa and total body irradiation (TBI) has been used as conditioning in haplo-identical transplantation. We studied this conditioning regimen in adults undergoing matched sibling transplantation and alternative donor transplantation. A total of 30 consecutive patients...

  • Graft dysfunction and delayed immune reconstitution following haploidentical peripheral blood hematopoietic stem cell transplantation. Ball, LM; Lankester, AC; Bredius, RGM; Fibbe, WE; van Tol, MJD; Egeler, RM // Bone Marrow Transplantation;Mar2005 Supplement 1, Vol. 35, p35 

    Summary:For many children with life-threatening hematological diseases, hematopoietic stem cell transplantation (HSCT) is the only curative option. In children lacking a matched related or unrelated donor and with the certainty that, left untreated, death will ensue alternative donors must be...

  • Growth Patterns and Gastrointestinal Symptoms in Pediatric Patients After Hematopoietic Stem Cell Transplantation. Rodgers, Cheryl; Wills-Alcoser, Patricia; Monroe, Rebecca; McDonald, Lisa; Trevino, Melisa; Hockenberry, Marilyn // Oncology Nursing Forum;May2008, Vol. 35 Issue 3, p443 

    Purpose/Objectives: To identify growth patterns and gastrointestinal (GI) symptoms in pediatric patients during the first four months after hematopoietic stem cell transplantation (HSCT) and to assess whether an association exists between acute graft-versus-host disease (GVHD) and growth pattern...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics