Eosinophilic pulmonary syndrome as a manifestation of GVHD following hematopoietic stem cell transplantation in three patients

Akhtari, Mojtaba; Langston, Amelia; Waller, Edmund K.; Gal, Anthony A.

doi:10.1038/bmt.2008.302

Cited by 12 publications

(6 citation statements)

References 11 publications

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“…Akhtari et al reported that eosinophilia is observed in patients with eosinophilic pulmonary syndrome after allo-HSCT [14], but there were no specific causes of eosinophilia in our cohort.…”

Section: Discussioncontrasting

confidence: 62%

Retrospective Study of Incidence and Prognostic Significance of Eosinophilia after Allogeneic Hematopoietic Stem Cell Transplantation: Influence of Corticosteroid Therapy

Yamamoto¹,

Ogusa²,

Matsumoto³

et al. 2016

Tjh

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Objective:The clinical significance of eosinophilia after allogeneic hematopoietic stem cell transplantation is controversial. This study aimed to retrospectively study the impact of eosinophilia on the outcome of allogeneic hematopoietic stem cell transplantation by taking into account the influence of corticosteroid therapy.Materials and Methods:We retrospectively studied 204 patients with acute myeloid leukemia, acute lymphoblastic leukemia, and myelodysplastic syndrome who underwent allogeneic hematopoietic stem cell transplantation from January 2001 to December 2010.Results:The median age was 43 years (minimum-maximum: 17-65 years). Myeloablative conditioning was used in 153 patients and reduced intensity conditioning was employed in 51 patients. Donor cells were from bone marrow in 132 patients, peripheral blood in 34, and cord blood in 38. Eosinophilia was detected in 71 patients and there was no significant predictor of eosinophilia by multivariate analysis. There was no relationship between occurrence of eosinophilia and the incidence or grade of acute graft-versus-host disease when the patients were stratified according to corticosteroid treatment. Although eosinophilia was a prognostic factor for 5-year overall survival by univariate analysis, it was not a significant indicator by multivariate analysis.Conclusion:These results suggest that the clinical significance of eosinophilia in patients receiving allogeneic hematopoietic stem cell transplantation should be assessed with consideration of systemic corticosteroid administration.

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Section: Discussioncontrasting

confidence: 62%

Retrospective Study of Incidence and Prognostic Significance of Eosinophilia after Allogeneic Hematopoietic Stem Cell Transplantation: Influence of Corticosteroid Therapy

Yamamoto¹,

Ogusa²,

Matsumoto³

et al. 2016

Tjh

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“…133,[135][136][137][138][139][140][141] As with lung biopsies in other immunocompromised hosts, it is of paramount importance to exclude infection, with judicious use of special stains for fungal, bacterial, and mycobacterial organisms, and even immunohistochemical studies to exclude viral infection such as cytomegalovirus and adenovirus (Fig. 133,[135][136][137][138][139][140][141] As with lung biopsies in other immunocompromised hosts, it is of paramount importance to exclude infection, with judicious use of special stains for fungal, bacterial, and mycobacterial organisms, and even immunohistochemical studies to exclude viral infection such as cytomegalovirus and adenovirus (Fig.…”

Section: Histopathology Of Lung Injury In Hematopoietic Stem Cell Tramentioning

confidence: 99%

“…One case report entailed collagenous alveolar septal fibrosis, similar to the fibrosing variant of nonspecific interstitial pneumonia, together with fibrosis and obliteration of respiratory bronchioles. 141 Although TMA is a significant comorbidity in HCT patients, it is rarely reported histopathologically in lung tissue specimens. The eosinophilic pulmonary syndrome of HCT involves predominantly small airways with some parenchymal infiltrates.…”

Section: Histopathology Of Lung Injury In Hematopoietic Stem Cell Tramentioning

confidence: 99%

Hematopoietic Stem Cell Transplantation

Kambham

Higgins

Sundram

et al. 2014

Advances in Anatomic Pathology

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Hematopoietic stem cell transplantation (HCT), formerly known as bone marrow transplantation, is an integral part of treatment for many hematological malignancies. HCT is associated with several complications and comorbidities with differential effects on a wide spectrum of organs and tissues. We present an update on HCT-associated complications such as graft versus host disease (GVHD) and infection, with focus on the surgical pathology of the gastrointestinal (GI) tract, liver, and lung. Although the grading system for GI tract acute GVHD was proposed 40 years ago, recent studies have shed light on minimal histologic criteria for diagnosis of GVHD, as well as its differential diagnosis, including histologic effects of various medications. GI dysfunction in autologous transplant recipients is increasingly appreciated and patients are often biopsied. Acute liver injury in HCT is often due to sinusoidal obstruction syndrome (previously known as venoocclusive disease), or acute GVHD. Liver dysfunction at later time posttransplantation may be associated with acute or chronic GVHD, iron overload, or other causes of hepatitis. Lung injury in HCT is multifactorial, and it remains crucially important to diagnose and treat pulmonary infections. The pulmonary biopsy yields clinically unsuspected diagnoses in the majority of cases and its utilization is likely to increase. The pathology of the skin and kidney in HCT patients are detailed in accompanying articles.

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“…Recently, eosinophilic pneumonia has been specified as pulmonary GVHD 16,17 . Interstitial pneumonia associated with infection (i.e.…”

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confidence: 99%

Non‐specific interstitial pneumonia as a manifestation of graft‐versus‐host disease following pediatric allogeneic hematopoietic stem cell transplantation

Miyagawa‐Hayashino

Sonobe

Kubo

et al. 2010

Pathology International

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Bronchiolitis obliterans (BO) is generally believed to be a marker of pulmonary manifestation of graft-versus-host disease (GVHD) in patients who have undergone bone marrow transplantation for hematological malignancy. Pulmonary manifestations reported as GVHD (other than BO) include lymphocytic bronchiolitis with cellular interstitial pneumonia, lymphoid interstitial pneumonia, veno-occlusive disease, and diffuse alveolar damage. Morphological reactions in the lungs of bone marrow transplant recipients associated with interstitial pneumonia have not been described systematically. Reported herein is a fibrosing non-specific interstitial pneumonia (NSIP) pattern together with BO in both lungs in an 8-year-old girl following a second allogeneic hematopoietic stem cell transplantation for relapsed neuroblastoma of adrenal origin. The course was complicated by bilateral pneumothoraces, and the patient underwent lung transplantation 3 years after the second stem cell transplantation. Because the patient had chronic GVHD of the skin and the liver preceeded by the development of pulmonary involvement, NSIP may represent one of the facets of pulmonary GVHD.

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Eosinophilic pulmonary syndrome as a manifestation of GVHD following hematopoietic stem cell transplantation in three patients

Cited by 12 publications

References 11 publications

Retrospective Study of Incidence and Prognostic Significance of Eosinophilia after Allogeneic Hematopoietic Stem Cell Transplantation: Influence of Corticosteroid Therapy

Retrospective Study of Incidence and Prognostic Significance of Eosinophilia after Allogeneic Hematopoietic Stem Cell Transplantation: Influence of Corticosteroid Therapy

Hematopoietic Stem Cell Transplantation

Non‐specific interstitial pneumonia as a manifestation of graft‐versus‐host disease following pediatric allogeneic hematopoietic stem cell transplantation

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