Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants

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

“…No patient-based factors, but several donor-based factors, were associated with the development of COP/BOOP: HLA disparity, female-to-male HCT and related PBSCT. These findings suggested that allogeneic reactive immunity may contribute to the development of COP/BOOP, as GVHD is thought to be associated with COP/BOOP, 8 and all of those three factors are known to be associated with GVHD. 23,24 Actually, in vivo T-cell depletion, which is thought to reduce allogeneic immunity and the risk of GVHD, also reduced the risk for the development of COP/BOOP in our cohort, although it was of borderline significance.…”

“…Although HLA was NS on univariate analysis, it was included into multivariate analysis because it is supposed to be the strong predictor for GVHD, which is also known to be associated with COP/BOOP. 8 In this analysis, the association between COP/BOOP and GVHD was assessed separately, as GVHD was supposed to be a post transplant factor, and the onset date of COP/BOOP was not available in the registry database. The associations with severity and target organs of GVHD were independently assessed.…”

“…Because COP/BOOP is a post transplant event, the control group without COP/BOOP might potentially include the patients who died before the COP/BOOP usually developed. 8 Therefore, OS and NRM were compared between the groups among the patients who survived for at least 30, 100, 180 and 365 days after allogeneic HCT. Of the 193 patients with COP/BOOP, 193 (100%), 182 (94%), 167 (87%) and 137 (71%) recipients were included in the corresponding OS analysis.…”

“…2,3,[5][6][7] The incidence of COP/ BOOP after HCT has been reported to range from 1 to 10%, and it appears at a median of 100 days or later after HCT. 2,3 Although COP/BOOP has been reported to respond to steroid treatment, [8][9][10][11][12] recurrence is often observed and prolonged steroid treatment is frequently required. 2,3,5,9 COP/BOOP occasionally progresses to thoracic air-leak syndrome and can be refractory to treatment.…”

“…6,7,[10][11][12][14][15][16][17] To the best of our knowledge, only one report, from Seattle, has included more than 20 cases (49 cases with COP/BOOP). 8 Thus, we performed a large retrospective study that included about 200 patients with COP/BOOP.…”