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Prepublished online as a Blood First Edition Paper on August 7, 2003; DOI 10.1182/blood-2002-10-3289. This Article Full Text (PDF) All Versions of this Article: 2002-10-3289v1 102/12/4236    most recent Alert me when this article is cited Alert me if a correction is posted 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 Sakaida, E. Articles by Nishimura, M. Search for Related Content PubMed PubMed Citation Articles by Sakaida, E. Articles by Nishimura, M. Social Bookmarking                   What's this? Submitted November 4, 2002 Accepted July 29, 2003 Late-onset non-infectious pulmonary complications after allogeneic stem cell transplantation are significantly associated with chronic graft-versus host disease and with the graft-versus-leukemia effect Emiko Sakaida, Chiaki Nakaseko*, Akane Harima, Akira Yokota, Ryuko Cho, Yasushi Saito, and Miki Nishimura Division of Hematology, Department of Clinical Cell Biology, Chiba University Graduate School of Medicine, Chiba, Japan * Corresponding author; email: chiaki-nakaseko{at}faculty.chiba-u.jp. Late-onset non-infectious pulmonary complications (LONIPC) occurring beyond three months post-allogeneic stem cell transplantation (allo-SCT) have become recognized as life-threatening complications, and they reduce the recipient's quality of life. However, the pathogenesis and optimal treatment for LONIPC are still unclear. In this study, we retrospectively analyzed the incidence and outcome of LONIPC among allo-SCT recipients. Between October 1993 and September 2001, ninety-six patients underwent allo-SCT and 76 patients who survived and were free of disease over three months after SCT were enrolled. Among the 76 patients, 18 patients (23.7%) developed LONIPC at a median interval of 227 days after allo-SCT (range, 91-1105 days). The patients with LONIPC were sub-classified into those with bronchiolitis obliterans (BO) (6 patients), with interstitial pneumonia (IP) (11 patients) or with both BO and IP (one patient). The presence of extensive chronic graft-versus-host disease (GVHD) was significantly associated with the development of LONIPC (P=0.0008). Liver or skin involvement in chronic GVHD was not associated, but sicca syndrome was significantly associated with the development of LONIPC (P<0.0001). Most of the IP patients (58.3%) responded well to immunosuppressive treatment, while BO patients didn't respond to the therapy. Eight of the 18 patients with LONIPC died. The major cause of death was respiratory failure (62.5%). The relapse rate of primary malignant disease in the LONIPC patients was significantly lower than that of non-LONIPC patients (1/17, 5.9% vs. 16/52, 30.8%; P=0.0387). These results indicate that the development of LONIPC was strongly associated with chronic GVHD, and especially with sicca syndrome and the graft-versus-leukemia (GVL) effect. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: A. O. Soubani and J. P. Uberti Bronchiolitis obliterans following haematopoietic stem cell transplantation Eur. Respir. J., May 1, 2007; 29(5): 1007 - 1019. [Abstract] [Full Text] [PDF] M. Ditschkowski, A. H. Elmaagacli, R. Trenschel, R. Peceny, M. Koldehoff, C. Schulte, and D. W. Beelen T-cell depletion prevents from bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia after allogeneic hematopoietic stem cell transplantation with related donors Haematologica, April 1, 2007; 92(4): 558 - 561. [Abstract] [Full Text] [PDF]

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