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Imatinib for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 50, pages 1250–1252 (2015)Cite this article

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Bronchiolitis obliterans (BO) is a fibroproliferative disorder that leads to epithelial injury and fibrotic constriction of the bronchioles. It is associated with various conditions, such as allogeneic hematopoietic stem cell transplantation (allo-SCT), lung transplantation, viral infections, connective tissue disease and exposure to toxic fumes.1 BO is a major cause of morbidity and mortality following allo-SCT, with an overall survival rate of only 13% at 5 years.2, 3 As is often the case with a fibrotic disorder, BO responds poorly to corticosteroids or immunosuppressants once it develops. Therefore, new treatment options are urgently needed to inhibit the progression of BO.

Molecular-targeted therapy is currently used to treat various malignancies. Tyrosine kinase inhibitors (TKIs) such as imatinib, nilotinib and dasatinib are now common treatments for Philadelphia chromosome-positive CML and acute lymphoid leukemia.4 Their targets include PDGF receptor (PDGFR), and the tyrosine kinases c-Abl, and c-Kit.4 Several studies have shown that imatinib can ameliorate chronic GVHD (cGVHD).5, 6, 7 However, there are few published reports of studies that have focused on the efficacy of TKIs used to treat BO associated with cGVHD. Here, we describe two patients who had undergone allogeneic hematopoietic stem cell transplantation (allo-SCT) and developed biopsy-proven BO that was successfully treated with TKIs.

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Acknowledgements

We thank Dr Ichiro Yamadori, Department of Pathology, Hiroshima City Hiroshima Citizens Hospital, Japan, for his valuable comments on the lung biopsy findings.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Ishikawa,, Japan

    S Watanabe, Y Waseda, H Kimura, H Takato & K Kasahara

  2. Department of Hematology, Cellular Transplantation Biology, Kanazawa University Graduate School of Medicine, Ishikawa, Japan

    K Ohata, Y Kondo & S Nakao

Authors
  1. S Watanabe
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  2. Y Waseda
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  3. H Kimura
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  4. H Takato
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  6. Y Kondo
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  7. K Kasahara
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  8. S Nakao
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Correspondence to Y Waseda.

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Watanabe, S., Waseda, Y., Kimura, H. et al. Imatinib for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 50, 1250–1252 (2015). https://doi.org/10.1038/bmt.2015.120

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