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Post-Transplant Events

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

Bone Marrow Transplantation volume 45, pages 1719–1727 (2010)Cite this article

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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.

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Acknowledgements

We thank the members of the Department of Emergency and Critical Care Medicine, the Department of Respiratory Medicine and the Department of Cardiothoracic Surgery, Graduate School of Medicine, University of Tokyo, for providing excellent care of the patients with lung complications after allo-HSCT.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    K Ueda, K Kataoka, S Seo, A Hangaishi, T Takahashi, Y Imai, Y Nannya & M Kurokawa

  2. Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    T Watadani, E Maeda & K Ohtomo

  3. Department of Pathology and Diagnostic Pathology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    S Ota & M Fukayama

  4. Department of Cell Therapy and Transplantation Medicine, University of Tokyo Hospital, Tokyo, Japan

    K Kumano & M Kurokawa

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  1. K Ueda
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Correspondence to M Kurokawa.

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Authorship: KU conceived and designed the study, collected the data and wrote the paper; TW and EM reviewed CT; SO reviewed pathology; K Kataoka collected the data; SS, K Kumano, AH, TT and YI provided clinical care; KO and MF supervised the study; YN designed the study and wrote the paper; MK supervised the study and approved the paper.

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Ueda, K., Watadani, T., Maeda, E. et al. Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT. Bone Marrow Transplant 45, 1719–1727 (2010). https://doi.org/10.1038/bmt.2010.48

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