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Microbial Issues

Pre-transplant risk factors for cryptogenic organizing pneumonia/bronchiolitis obliterans organizing pneumonia after hematopoietic cell transplantation

Bone Marrow Transplantation volume 48, pages 1317–1323 (2013)Cite this article

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A Corrigendum to this article was published on 09 October 2013

This article has been updated

Abstract

Cryptogenic organizing pneumonia (COP), previously known as bronchiolitis obliterans organizing pneumonia (BOOP), is a significant complication after allogeneic hematopoietic SCT (HCT). However, the pathogenesis of this complication has not yet been elucidated. Therefore, we identified the pre-transplant risk factors for the development of COP/BOOP using the Japan transplant registry database between 2005 and 2009. Among 9550 eligible recipients, 193 experienced COP/BOOP (2%). HLA disparity (odds ratio (OR) 1.51, P=0.05), female-to-male HCT (OR 1.53, P=0.023), and PBSC transplant (OR 1.84, P=0.0076) were significantly associated with an increased risk of COP/BOOP. On the other hand, BU-based myeloablative conditioning (OR 0.52, P=0.033), or fludarabine-based reduced-intensity conditioning (OR 0.50, P=0.0011) in comparison with a TBI-based regimen and in vivo T-cell depletion (OR 0.46, P=0.055) were associated with a lower risk. Of the 193 patients with COP/BOOP, 77 died, including non-relapse death in 46 (59%). Pulmonary failure and fatal infection accounted for 41% (n=19) and 26% (n=12) of the non-relapse death. Allogeneic immunity and conditioning toxicity could be associated with COP/BOOP. Prospective studies are required to elucidate the true risk factors for COP/BOOP and to develop a prophylactic approach.

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Change history

  • 09 October 2013

    This article has been corrected since Advance Online Publication and a Corrigendum is also printed in this issue

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Acknowledgements

We greatly appreciate the work of all of the physicians and data managers at the centers that contributed valuable data on transplantation to the Japan Society for Hematopoietic Cell Transplantation (JSHCT), the Japanese Society of Pediatric Hematology and Oncology (JSPHO) the Japan Marrow Donor Program (JMDP) and the Japan Cord Blood Bank Network (JCBBN). We also thank all of the members of the Transplant Registry Unified Management committees at JSHCT, JSPHO, JMDP and JCBBN for their dedication.

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Author notes

  1. H Nakasone, M Onizuka, N Suzuki, N Fujii and T Fukuda: Working Group for Complications after HCT of the Japan Society for Hematopoietic Cell Transplantation

Authors and Affiliations

  1. Division of Bone and Marrow Transplantation, Stanford University School of Medicine, Stanford, CA, USA

    H Nakasone

  2. Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan

    H Nakasone

  3. Department of Hematology, Tokai University School of Medicine, Isehara, Japan

    M Onizuka

  4. Department of Pediatrics, Sapporo Medical University, Sapporo, Japan

    N Suzuki

  5. Department of Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

    N Fujii

  6. Department of Hematology, Toranomon Hospital, Tokyo, Japan

    S Taniguchi

  7. Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan

    K Kakihana & H Sakamaki

  8. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan

    H Ogawa

  9. Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    K Miyamura

  10. Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan

    T Eto

  11. Department of Cell Transplantation and Regenerative Medicine, Tokai University School of Medicine, Isehara, Japan

    H Yabe

  12. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan

    Y Morishima

  13. Department of Pediatric Hematology and Oncology, Children’s Medical Center, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan

    K Kato

  14. Department of Hematopoietic Stem Cell Transplantation Data Management and Biostatics, Nagoya University School of Medicine, Nagoya, Japan

    R Suzuki

  15. Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan

    T Fukuda

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  1. H Nakasone
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  2. M Onizuka
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  10. H Sakamaki
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Correspondence to H Nakasone.

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Author contributions

HN designed the study, analyzed data and wrote the manuscript. MO, NS and NF advised on methods, analyzed the data and wrote the manuscript. KK, TE, and KM collected the data. HS, HY, YM, and KK collected the data and were responsible for managing the data from JSHCT, JSPHO, JMDP and JCBBN, respectively. RS analyzed and managed the unified registry database, and wrote the manuscript. TF analyzed the data, wrote the manuscript and was responsible for the study and the Complications-Working Group of JSHCT.

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Nakasone, H., Onizuka, M., Suzuki, N. et al. Pre-transplant risk factors for cryptogenic organizing pneumonia/bronchiolitis obliterans organizing pneumonia after hematopoietic cell transplantation. Bone Marrow Transplant 48, 1317–1323 (2013). https://doi.org/10.1038/bmt.2013.116

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