Small-Airways Disease in Recipients of Allogeneic Bone Marrow Transplants Journal Articles uri icon

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abstract

  • In a retrospective review of 116 consecutive allogeneic bone marrow transplants (BMT), severe obstructive airways disease was identified in 11 patients. Lung pathology demonstrated bronchiolitis in 9 patients and physiologic studies showed small-airways disease consistent with bronchiolitis in the other 2. None of the 5 patients with associated infection survived, while 3 of the 6 patients without an identified pathogen stabilized or improved. Analysis of the 11 cases presented and all 25 cases reported in the literature (1982 to 1985) supports the conclusion that graft-versus-host disease is a major risk factor for bronchiolitis in BMT recipients. Among the proposed mechanisms for the development of bronchiolitis after allogeneic BMT, the 2 most likely are graft-versus-host disease directly causing bronchiolitis, and increased immunosuppressive therapy given for graft-versus-host disease predisposing to viral bronchiolitis. The available evidence would suggest that it is prudent to obtain serial pulmonary function tests even in asymptomatic patients post-BMT, and particularly in those with chronic graft-versus-host disease, in the hope that early detection will allow for early intervention that will arrest or reverse the progression of the obstructive airways disease.

authors

  • CHAN, CHARLES K
  • HYLAND, ROBERT H
  • HUTCHEON, MICHAEL A
  • MINDEN, MARK D
  • Alexander, Michael
  • KOSSAKOWSKA, ANNA E
  • URBANSKI, STEFAN J
  • FYLES, GILLIAN M
  • FRASER, IAN M
  • CURTIS, JOHN E
  • MESSNER, HANS A

publication date

  • September 1987