Abstract
Pulmonary complications develop in 30–60% of hematopoietic stem cell transplants (HSCT). The main, late onset, non-infectious complications include Bronchiolitis obliterans (BO), Bronchiolitis obliterans organizing pneumonia (BOOP), and idiopathic pneumonia syndrome (IPS). BO and BOOP occur almost exclusively in allogeneic HSCT, and have 61% and 21% mortality rates, respectively. BOOP responds favorably to corticosteroids. IPS has less than 15% 1-year survival. Bone Marrow Transplantation (2001) 28, 425–434.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Breuer R, Lossos IS, Berkman N et al. Pulmonary complications of bone marrow transplantation Respir Med 1993 87: 571–579
Cordonnier C, Bernaudin JF, Bierling P et al. Pulmonary complications occurring after allogeneic bone marrow transplantation. A study of 130 consecutive transplanted patients Cancer 1986 58: 1047–1054
Cerveri I, Zoia MC, Fulgoni P et al. Late pulmonary sequelae after childhood bone marrow transplantation Thorax 1999 54: 131–135
Griese M, Rampf U, Hofmann D et al. Pulmonary complications after bone marrow transplantation in children: twenty-four years of experience in a single pediatric center Pediatr Pulmonol 2000 30: 393–401
Milburn HJ, Prentice HG, du Bois RM . Can lung function measurements be used to predict which patients will be at risk of developing interstitial pneumonitis after bone marrow transplantation? Thorax 1992 47: 421–425
Horak DA, Schmidt GM, Zaia JA et al. Pretransplant pulmonary function predicts cytomegalovirus-associated interstitial pneumonia following bone marrow transplantation Chest 1992 102: 1484–1490
Crawford SW, Fisher L . Predictive value of pulmonary function tests before marrow transplantation Chest 1992 101: 1257–1264
Badier M, Guillot C, Delpierre S et al. Pulmonary function changes 100 days and one year after bone marrow transplantation Bone Marrow Transplant 1993 12: 457–461
Ghalie R, Szidon JP, Thompson L et al. Evaluation of pulmonary complications after bone marrow transplantation: the role of pretransplant pulmonary function tests Bone Marrow Transplant 1992 10: 359–365
Sullivan KM, Agura E, Anasetti C et al. Chronic graft-versus-host disease and other late complications of bone marrow transplantation Semin Hematol 1991 28: 250–259
Yousem SA . The histological spectrum of pulmonary graft-versus-host disease in bone marrow transplant recipients Hum Pathol 1995 26: 668–675
King TE Jr . Overview of bronchiolitis Clin Chest Med 1993 14: 607–610
Paz HL, Crilley P, Patchefsky A et al. Bronchiolitis obliterans after autologous bone marrow transplantation Chest 1992 101: 775–778
Clark JG, Crawford SW, Madtes DK et al. Obstructive lung disease after allogeneic marrow transplantation. Clinical presentation and course Ann Intern Med 1989 111: 368–376
Philit F, Wiesendanger T, Archimbaud E et al. ‘Post-transplant obstructive lung disease’: a clinical comparative study of bone marrow and lung transplant patients Eur Respir J 1995 8: 551–558
Palmas A, Tefferi A, Myers JL et al. Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation Br J Haematol 1998 100: 680–687
Holland HK, Wingard JR, Beschorner WE et al. Bronchiolitis obliterans in bone marrow transplantation and its relationship to chronic graft-v-host disease and low serum IgG Blood 1988 72: 621–627
Schultz KR, Green GJ, Wensley D et al. Obstructive lung disease in children after allogeneic bone marrow transplantation Blood 1994 84: 3212–3220
Urbanski SJ, Kossakowska AE, Curtis J et al. Idiopathic small airways pathology in patients with graft-versus-host disease following allogeneic bone marrow transplantation Am J Surg Pathol 1987 11: 965–971
Lund MB, Kongerud J, Brinch L et al. Decreased lung function in one year survivors of allogeneic bone marrow transplantation conditioned with high-dose busulphan and cyclophosphamide Eur Respir J 1995 8: 1269–1274
Curtis DJ, Smale A, Thien F et al. Chronic airflow obstruction in long-term survivors of allogeneic bone marrow transplantation Bone Marrow Transplant 1995 16: 169–173
Chan CK, Hyland RH, Hutcheon MA et al. Small-airways disease in recipients of allogeneic bone marrow transplants. An analysis of 11 cases and a review of the literature Med (Balt) 1987 66: 327–340
Ralph DD, Springmeyer SC, Sullivan KM et al. Rapidly progressive air-flow obstruction in marrow transplant recipients. Possible association between obliterative bronchiolitis and chronic graft-versus-host disease Am Rev Respir Dis 1984 129: 641–644
Clark JG, Schwartz DA, Flournoy N et al. Risk factors for airflow obstruction in recipients of bone marrow transplants Ann Intern Med 1987 107: 648–656
Crawford SW, Clark JG . Bronchiolitis associated with bone marrow transplantation Clin Chest Med 1993 14: 741–749
St John RC, Gadek JE, Tutschka PJ et al. Analysis of airflow obstruction by bronchoalveolar lavage following bone marrow transplantation. Implications for pathogenesis and treatment Chest 1990 98: 600–607
Krowka MJ, Rosenow EC III, Hoagland HC . Pulmonary complications of bone marrow transplantation Chest 1985 87: 237–246
Hyland RH, Chan CK, Hutcheon MA et al. Early diagnosis of obstructive airways disease after allogeneic bone marrow transplantation may improve outcome Am Rev Respir Dis 1988 137: (Suppl. 111) (Abstr.)
Cooper JD, Billingham M, Egan T et al. A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation J Heart Lung Transplant 1993 12: 713–716
Savage DG, Taylor P, Blackwell J et al. Paranasal sinusitis following allogeneic bone marrow transplant Bone Marrow Transplant 1997 19: 55–59
Billings KR, Lowe LH, Aquino VM et al. Screening sinus CT scans in pediatric bone marrow transplant patients Int J Pediatr Otorhinolaryngol 2000 52: 253–260
McDonald GB, Sullivan KM, Plumley TF . Radiographicfeatures of esophageal involvement in chronic graft-vs-hostdisease Am J Roentgenol 1984 142: 501–506
Johnson FL, Stokes DC, Ruggiero M et al. Chronic obstructive airways disease after bone marrow transplantation J Pediatr 1984 105: 370–376
Ostrow D, Buskard N, Hill RS et al. Bronchiolitis obliterans complicating bone marrow transplantation Chest 1985 87: 828–830
Wyatt SE, Nunn P, Hows JM et al. Airways obstruction associated with graft-versus-host disease after bone marrow transplantation Thorax 1984 39: 887–894
Hackman RC, Madtes DK, Petersen FB et al. Pulmonary veno-occlusive disease following bone marrow transplantation Transplantation 1989 47: 989–992
Boas SR, Noyes BE, Kurland G et al. Pediatric lung transplantation for graft-versus-host disease following bone marrow transplantation Chest 1994 105: 1584–1586
Nagai H, Shishido H, Yoneda R et al. Long-term low-dose administration of erythromycin to patients with diffuse panbronchiolitis Respiration 1991 58: 145–149
Kudoh S, Azuma A, Yamamoto M et al. Improvement of survival in patients with diffuse panbronchiolitis treated with low-dose erythromycin Am J Respir Crit Care Med 1998 157: 1829–1832
Kudoh S . Erythromycin treatment in diffuse panbronchiolitis Curr Opin Pulm Med 1998 4: 116–121
Ichikawa Y, Ninomiya H, Koga H et al. Erythromycin reduces neutrophils and neutrophil-derived elastolytic-like activity in the lower respiratory tract of bronchiolitis patients Am Rev Respir Dis 1992 146: 196–203
Oda H, Kadota J, Kohno S et al. Erythromycin inhibits neutrophil chemotaxis in bronchoalveoli of diffuse panbronchiolitis Chest 1994 106: 1116–1123
Forsyth CJ, Cremer PD, Torzillo P et al. Thalidomide responsive chronic pulmonary GVHD Bone Marrow Transplant 1996 17: 291–293
Browne PV, Weisdorf DJ, DeFor T et al. Response to thalidomide therapy in refractory chronic graft-versus-host disease Bone Marrow Transplant 2000 26: 865–869
Sullivan KM, Storek J, Kopecky KJ et al. A controlled trial of long-term administration of intravenous immunoglobulin to prevent late infection and chronic graft-vs-host disease after marrow transplantation: clinical outcome and effect on subsequent immune recovery Biol Blood Marrow Transplant 1996 2: 44–53
Payne L, Chan CK, Fyles G et al. Cyclosporine as possible prophylaxis for obstructive airways disease after allogeneic bone marrow transplantation Chest 1993 104: 114–118
Paz HL, Crilley P, Topolsky DL et al. Bronchiolitis obliterans after bone marrow transplantation: the effect of preconditioning Respiration 1993 60: 109–114
Thirman MJ, Devine SM, O'Toole K et al. Bronchiolitis obliterans organizing pneumonia as a complication of allogeneic bone marrow Bone Marrow Transplant 1992 10: 307–311
Mathew P, Bozeman P, Krance RA et al. Bronchiolitis obliterans organizing pneumonia (BOOP) in children after allogeneic bone marrow transplantation Bone Marrow Transplant 1994 13: 221–223
Alasaly K, Muller N, Ostrow DN et al. Cryptogenic organizing pneumonia. A report of 25 cases and a review of the literature Med (Balt) 1995 74: 201–211
Kleinau I, Perez-Canto A, Schmid HJ et al. Bronchiolitis obliterans organizing pneumonia and chronic graft-versus-host disease in a child after allogeneic bone marrow transplantation Bone Marrow Transplant 1997 19: 841–844
Kanda Y, Takahashi T, Imai Y et al. Bronchiolitis obliterans organizing pneumonia after syngeneic bone marrow transplantation for acute lymphoblastic leukemia Bone Marrow Transplant 1997 19: 1251–1253
Ishii T, Manabe A, Ebihara Y et al. Improvement in bronchiolitis obliterans organizing pneumonia in a child after allogeneic bone marrow transplantation by a combination of oral prednisolone and low dose erythromycin Bone Marrow Transplant 2000 26: 907–910
Przepiorka D, Abu-Elmagd K, Huaringa A et al. Bronchiolitis obliterans organizing pneumonia in a BMT patient receiving FK506 Bone Marrow Transplant 1993 11: 502 (letter)
Baron FA, Hermanne JP, Dowlati A et al. Bronchiolitisobliterans organizing pneumonia and ulcerative colitis after allogeneic bone marrow transplantation Bone Marrow Transplant 1998 21: 951–954
Epler GR . Bronchiolitis obliterans organizing pneumonia Semin Respir Infect 1995 10: 65–77
Muller NL, Staples CA, Miller RR . Bronchiolitis obliterans organizing pneumonia: CT features in 14 patients Am J Roentgenol 1990 154: 983–987
Worthy SA, Flint JD, Muller NL . Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings Radiographics 1997 17: 1359–1371
Graham NJ, Muller NL, Miller RR et al. Intrathoracic complications following allogeneic bone marrow transplantation: CT findings Radiology 1991 181: 153–156
Myers JL, Colby TV . Pathologic manifestations of bronchiolitis, constrictive bronchiolitis, cryptogenic organizing pneumonia, and diffuse panbronchiolitis Clin Chest Med 1993 14: 611–622
Cordier JF . Organising pneumonia Thorax 2000 55: 318–328
Clark JG, Hansen JA, Hertz MI et al. NHLBI Workshop Summary. Idiopathic pneumonia syndrome after bone marrow transplantation Am Rev Respir Dis 1993 147: 1601–1606
Meyers JD, Flournoy N, Thomas ED . Nonbacterial pneumonia after allogeneic marrow transplantation: a review of ten years' experience Rev Infect Dis 1982 4: 1119–1132
Wingard JR, Mellits ED, Sostrin MB et al. Interstitial pneumonitis after allogeneic bone marrow transplantation. Nine-year experience at a single institution Med (Balt) 1988 67: 175–186
Weiner RS, Bortin MM, Gale RP et al. Interstitial pneumonitis after bone marrow transplantation. Assessment of risk factors Ann Intern Med 1986 104: 168–175
Crawford SW, Longton G, Storb R . Acute graft-versus-host disease and the risks for idiopathic pneumonia after marrow transplantation for severe aplastic anemia Bone Marrow Transplant 1993 12: 225–231
Kantrow SP, Hackman RC, Boeckh M et al. Idiopathic pneumonia syndrome: changing spectrum of lung injury after marrow transplantation Transplantation 1997 63: 1079–1086
Wingard JR, Sostrin MB, Vriesendorp HM et al. Interstitial pneumonitis following autologous bone marrow transplantation Transplantation 1988 46: 61–65
Valteau D, Hartmann O, Benhamou E et al. Nonbacterial nonfungal interstitial pneumonitis following autologous bone marrow transplantation in children treated with high-dose chemotherapy without total-body irradiation Transplantation 1988 45: 737–740
Pecego R, Hill R, Appelbaum FR et al. Interstitial pneumonitis following autologous bone marrow transplantation Transplantation 1986 42: 515–517
Granena A, Carreras E, Rozman C et al. Interstitial pneumonitis after BMT: 15 years experience in a single institution Bone Marrow Transplant 1993 11: 453–458
Nomura F, Shimokata K, Sakai S et al. Cytomegalovirus pneumonitis occurring after allogeneic bone marrow transplantation: a study of 106 recipients Jpn J Med 1990 29: 595–602
Atkinson K, Nivison-Smith I, Dodds A et al. A comparison of the pattern of interstitial pneumonitis following allogeneic bone marrow transplantation before and after the introduction of prophylactic ganciclovir therapy in 1989 Bone Marrow Transplant 1998 21: 691–695
Crawford SW, Hackman RC . Clinical course of idiopathic pneumonia after bone marrow transplantation Am Rev Respir Dis 1993 147: 1393–1400
Kudoh T, Suzuki N, Oda T et al. Pneumomediastinum, subcutaneous emphysema, and pulmonary fibrosis in a patient with idiopathic pneumonia syndrome after bone marrow transplantation Pediatr Hematol Oncol 2000 17: 113–117
Crawford SW, Hackman RC . Clinical course of idiopathic pneumonia after bone marrow transplantation Am Rev Respir Dis 1993 147: 1393–1400
Robbins RA, Linder J, Stahl MG et al. Diffuse alveolar hemorrhage in autologous bone marrow transplant recipients Am J Med 1989 87: 511–518
Metcalf JP, Rennard SI, Reed EC et al. Corticosteroids as adjunctive therapy for diffuse alveolar hemorrhage associated with bone marrow transplantation. University of Nebraska Medical Center Bone Marrow Transplant Group Am J Med 1994 96: 327–334
Witte RJ, Gurney JW, Robbins RA et al. Diffuse pulmonary alveolar hemorrhage after bone marrow transplantation: radiographic findings in 39 patients Am J Roentgenol 1991 157: 461–464
Marasco WJ, Fishman EK, Kuhlman JE et al. Acute pulmonary hemorrhage. CT evaluation Clin Imaging 1993 17: 77–80
Chao NJ, Duncan SR, Long GD et al. Corticosteroid therapy for diffuse alveolar hemorrhage in autologous bone marrow transplant recipients Ann Intern Med 1991 114: 145–146
Haselton DJ, Klekamp JG, Christman BW et al. Use of high-dose corticosteroids and high-frequency oscillatory ventilation for treatment of a child with diffuse alveolar hemorrhage after bone marrow transplantation: case report and review of the literature Crit Care Med 2000 28: 245–248
Raptis A, Mavroudis D, Suffredini A et al. High-dose corticosteroid therapy for diffuse alveolar hemorrhage in allogeneic bone marrow stem cell transplant recipients Bone Marrow Transplant 1999 24: 879–883
Jules-Elysee K, Stover DE, Yahalom J et al. Pulmonary complications in lymphoma patients treated with high-dose therapy autologous bone marrow transplantation Am Rev Respir Dis 1992 146: 485–491
Huaringa AJ, Leyva FJ, Giralt SA et al. Outcome of bone marrow transplantation patients requiring mechanical ventilation Crit Care Med 2000 28: 1014–1017
Capizzi SA, Kumar S, Huneke NE et al. Peri-engraftment respiratory distress syndrome during autologous hematopoietic stem cell transplantation Bone Marrow Transplant 2001 27: 1299–1303
Wilczynski SW, Erasmus JJ, Petros WP et al. Delayed pulmonary toxicity syndrome following high-dose chemotherapy and bone marrow transplantation for breast cancer Am J Respir Crit Care Med 1998 157: 565–573
Bhalla KS, Wilczynski SW, Abushamaa AM et al. Pulmonary toxicity of induction chemotherapy prior to standard or high-dose chemotherapy with autologous hematopoietic support Am J Respir Crit Care Med 2000 161: 17–25
Woodard JP, Gulbahce E, Shreve M et al. Pulmonary cytolytic thrombi: a newly recognized complication of stem cell transplantation Bone Marrow Transplant 2000 25: 293–300
Gulbahce HE, Manivel JC, Jessurun J . Pulmonary cytolytic thrombi: a previously unrecognized complication of bone marrow transplantation Am J Surg Pathol 2000 24: 1147–1152
Seguchi M, Hirabayashi N, Fujii Y et al. Pulmonary hypertension associated with pulmonary occlusive vasculopathy after allogeneic bone marrow transplantation Transplantation 2000 69: 177–179
Griese M, Bender-Gotze C . Hepatopulmonary syndrome after allogeneic bone marrow transplantation Bone Marrow Transplant 1999 24: 1249–1252
Cordonnier C, Fleury-Feith J, Escudier E et al. Secondary alveolar proteinosis is a reversible cause of respiratory failure in leukemic patients Am J Respir Crit Care Med 1994 149: 788–794
Gross TG, Hoge FJ, Jackson JD et al. Fatal eosinophilic disease following autologous bone marrow transplantation Bone Marrow Transplant 1994 14: 333–337
Bensinger WI, Martin PJ, Storer B et al. Transplantation of bone marrow as compared with peripheral-blood cells from HLA-identical relatives in patients with hematologic cancers N Engl J Med 2001 344: 175–181
Acknowledgements
We thank Dr Jeffrey L Myers for providing us with the pathology slides and legends.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Afessa, B., Litzow, M. & Tefferi, A. Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplant 28, 425–434 (2001). https://doi.org/10.1038/sj.bmt.1703142
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.bmt.1703142
Keywords
This article is cited by
-
Contributions of cancer treatment, comorbidities, and obesity to aging-related disease risks among non-Hodgkin lymphoma survivors
Cancer Causes & Control (2023)
-
Interstitial lung disease with anti-melanoma differentiation-associated gene 5 antibody after allogeneic hematopoietic stem cell transplantation
Bone Marrow Transplantation (2022)
-
Pleuroparenchymal fibroelastosis after hematopoietic stem cell transplantation in children: a propensity score–matched analysis
European Radiology (2022)
-
Risk factors and prognosis of non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation
International Journal of Hematology (2022)
-
Incidence and predictors of idiopathic pneumonia syndrome in hematopoietic stem cell transplant patients: a nationwide registry study
International Journal of Hematology (2022)