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Blood, 15 October 2003, Vol. 102, No. 8, pp. 2777-2785. Prepublished online as a Blood First Edition Paper on July 10, 2003; DOI 10.1182/blood-2003-05-1597. This Article Full Text Full Text (PDF) All Versions of this Article: 2003-05-1597v1 102/8/2777    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Fukuda, T. Articles by Madtes, D. K. Search for Related Content PubMed PubMed Citation Articles by Fukuda, T. Articles by Madtes, D. K. Related Collections Neoplasia Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Risks and outcomes of idiopathic pneumonia syndrome after nonmyeloablative and conventional conditioning regimens for allogeneic hematopoietic stem cell transplantation Takahiro Fukuda, Robert C. Hackman, Katherine A. Guthrie, Brenda M. Sandmaier, Michael Boeckh, Michael B. Maris, David G. Maloney, H. Joachim Deeg, Paul J. Martin, Rainer F. Storb, and David K. Madtes From the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and the Department of Pathology and Laboratory Medicine and the Department of Medicine, University of Washington School of Medicine, Seattle. Idiopathic pneumonia syndrome (IPS) is a significant noninfectious complication of hematopoietic stem cell transplantation (HSCT). We compared the incidences and outcomes of IPS among patients who underwent allogeneic HSCT after nonmyeloablative (n = 183) compared with conventional (n = 917) conditioning between December 1997 and December 2001. Patients given nonmyeloablative conditioning were older than those given conventional conditioning (median ages, 53 vs 41 years; P = .001). The cumulative incidence of IPS was significantly lower at 120 days after nonmyeloablative conditioning than conventional conditioning (2.2% vs 8.4%; P = .003). In addition, greater patient age (older than 40 years), diagnosis of acute leukemia or myelodys-plastic syndrome, and severe acute graft-versus-host disease were associated with significantly increased risks for IPS. Among older patients (older than 40 years) given conventional conditioning, high-dose total body irradiation (TBI) was associated with an increased risk for IPS than were non-TBI–based regimens (16% vs 5.8%; P = .001). IPS occurred early after transplantation, progressed rapidly, and was associated with a high mortality rate (75%) despite aggressive support. Initiation of mechanical ventilation and the presence of renal insufficiency at IPS onset were associated with increased risks for death after IPS. These findings support the concept that lung damage from the conditioning regimen plays a crucial role in the development of IPS after HSCT. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: G. Hildebrandt The lung's friend, the gut's foe Blood, August 1, 2007; 110(3): 792 - 793. [Full Text] [PDF] C. Cutler, S. Li, V. T. Ho, J. Koreth, E. Alyea, R. J. Soiffer, and J. H. Antin Extended follow-up of methotrexate-free immunosuppression using sirolimus and tacrolimus in related and unrelated donor peripheral blood stem cell transplantation Blood, April 1, 2007; 109(7): 3108 - 3114. [Abstract] [Full Text] [PDF] D. S. 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