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Post-Transplant Complications

Mediastinal emphysema and bilateral pneumothoraces with chronic GVHD in patients after allogeneic stem cell transplantation

Bone Marrow Transplantation volume 33, pages 1159–1163 (2004)Cite this article

Summary:

It is difficult to treat lung complications caused by chronic graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (allo-SCT). We retrospectively analyzed the characteristics of five patients with mediastinal emphysema (ME) and bilateral pneumothoraces (BP) caused by chronic lung GVHD after allo-SCT. Four of these patients had undergone unrelated SCT, and three had had HLA-identical unrelated donors. All patients received total body irradiation (TBI) during conditioning. Immunosuppressive agents were administered as GHVD prophylaxis, but two patients developed acute GVHD and all the five developed chronic GVHD. The onset of lung complications was 99–1915 days (median, 202 days) after SCT. The onset of ME and BP was 6–48 days (median, 23 days) after the onset of lung complications. Immunosuppressive agents were initially beneficial on the lung complications, but the patients later showed no response to therapy, and all died from respiratory failure 7–195 days (median, 28 days) after the development of ME and BP. The results suggest that these complications progress rapidly, are resistant to treatment, and have a poor prognosis. It is therefore important to start prophylaxis and treatment as early as possible.

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Authors and Affiliations

  1. Department of Hematology, Sapporo Hokuyu Hospital, Japan

    T Toubai, N Kobayashi, Y Miura, T Ogawa, K Imai, M Ogasawara, Y Kiyama, T Higa & M Kasai

  2. Department of Hematology and Oncology, Hokkaido University Graduate School of Medicine, Japan

    T Toubai, J Tanaka, Y Miura & M Imamura

  3. Department of Respiratology, Sapporo Hokuyu Hospital, Japan

    T Honda

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  1. T Toubai
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Correspondence to T Toubai.

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Toubai, T., Tanaka, J., Kobayashi, N. et al. Mediastinal emphysema and bilateral pneumothoraces with chronic GVHD in patients after allogeneic stem cell transplantation. Bone Marrow Transplant 33, 1159–1163 (2004). https://doi.org/10.1038/sj.bmt.1704491

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