Lung Transplantation for Bronchiolitis Obliterans After Allogenic Bone Marrow Transplantation

Redel-Montero, Javier; Bujalance-Cabrera, Carlos; Vaquero-Barrios, J.M.; Santos-Luna, Francisco; Larriva, Marisol Arenas-De; Moreno, Paula; Espinosa-Jiménez, D.

doi:10.1016/j.transproceed.2010.07.086

Cited by 14 publications

(14 citation statements)

References 9 publications

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“…However, the efficacy and long-term results of adding such methods to the treatment for BO following HSCT is not yet known. There are a few reports of LT for BO following HSCT since Calhoon, et al5 first reported a case in a 25 year old woman with acute lymphoblastic leukemia and restrictive lung disease treated with single LT following HSCT 3,13-15. Recently, Oshima, et al16 reported a living-donor lobar lung transplantation for therapy-resistant BO after allogenetic HSCT from the same donor of bone marrow.…”

Section: Discussionmentioning

confidence: 99%

“…However, chronic graft-versus-host disease (GVHD) is a major complication and a main cause of late mortality following allogeneic HSCT 2-4. Bronchiolitis obliterans (BO) is a late onset noninfectious pulmonary complication occurring in 10% to 15% of patients with extensive chronic GVHD 3. The mortality rate of BO after HSCT is very high, although BO is treated with high-dose systemic corticosteroid and immunosuppressive agents as in chronic GVHD.…”

Section: Introductionmentioning

confidence: 99%

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Lung Transplantation for Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation

et al. 2012

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Bronchiolitis obliterans (BO) is a late onset complication of allogeneic hematopoietic stem cell transplantation (HSCT), and treatment outcome is dismal if it does not respond to immunosuppressive therapy. A 21-year-old male diagnosed with acute myeloid leukemia received an allogeneic HSCT from human leukocyte antigen- identical sibling donor. Twenty one months after transplantation, he developed progressive dyspnea and was diagnosed BO. Despite standard immunosuppressive therapy, the patient rapidly progressed to respiratory failure and Novalung® interventional lung-assist membrane ventilator was applied in the intensive care unit. Three months after the diagnosis of BO, the patient underwent bilateral lung transplantation (LT) and was eventually able to wean from the ventilator and the Novalung®. Since the LT, the patient has been under a strict rehabilitation program in order to overcome a severe lower extremity weakness and muscle atrophy. Histologic findings of the explanted lungs confirmed the diagnosis of BO. Nine months after the LT, the patient showed no signs of rejection or infectious complications, but still required rehabilitation treatment. This is the first LT performed in a patient with BO after allogeneic HSCT in Korea. LT can be an effective therapy in terms of survival for patients with respiratory failure secondary to development of BO following HSCT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lung Transplantation for Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation

et al. 2012

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“…[74][75][76][77][78][79] However, additional studies are required to determine the role and benefit of macrolide therapy in OB/BOS. Single-lung transplantation has been successful in some cases of OB, [80][81][82][83][84] but OB accounts for <1% of all indications in the Registry of the International Society for Heart and Lung Transplantation (ISHLT). 85 The sections that follow discuss specific disorders associated with OB.…”

Section: Prognosis and Therapymentioning

confidence: 99%

“…Finally, lung transplantation is an option for life-threatening OB/BOS recalcitrant to medical therapy. 80,81,[276][277][278][279] Connective Tissue Disease OB is a rare complication of CTD, 25 principally RA. 26 The association of OB and RA was initially reported in 1977 by Geddes et al, who described six patients (five of whom had RA) with rapidly progressive dyspnea and severe airflow obstruction.…”

Section: Clinical Coursementioning

confidence: 99%

Obliterative (Constrictive) Bronchiolitis

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Derhovanessian

et al. 2012

Semin Respir Crit Care Med

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Obliterative bronchiolitis (OB) (formerly termed bronchiolitis obliterans), is a rare fibrotic disorder involving terminal and respiratory bronchioles. The term constrictive bronchiolitis is synonymous with OB. Clinically, OB is characterized by progressive (often fatal) airflow obstruction, the absence of parenchymal infiltrates on chest radiographs, a mosaic pattern of perfusion on high-resolution computed tomographic scan, poor responsiveness to therapy, and high mortality rates. Most cases of OB occur in the context of a specific risk factor. Currently, most cases of OB occur in lung transplant recipients with chronic allograft rejection or hematopoietic stem cell transplant (HSCT) recipients with graft versus host disease (GVHD). Other causes of OB include connective tissue disease (CTD) (particularly rheumatoid arthritis); lower respiratory tract infections; inhalation injury; exposure or inhalation of toxic fumes, metals, dusts, particulate matter, or pollutants; occupational exposures; drug reactions; consumption of uncooked leaves of Sauropus androgynus; chronic hypersensitivity pneumonia; diffuse neuroendocrine cell hyperplasia; miscellaneous. When no cause is identified, the term cryptogenic obliterative bronchiolitis is used. This review discusses the salient clinical, radiographic, and histological features of OB and presents a management approach.

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“…[6][7][8][9] Lung transplantation (LTx) could be a therapeutic option for selected patients developing severe lung dysfunction in the course of cGVHD/BOS, and several case reports have been published. [10][11][12][13] According to the registry of the International Society of Heart and Lung Transplantation (ISHLT), in the period from 1995 to 2010, 1% of all LTx were performed due to obliterative bronchiolitis (retransplants excluded), 14 but the proportion of these that have previously had a hematopoietic SCT is not registered (Edwards L, ISHLT, personal communication).…”

Section: Introductionmentioning

confidence: 99%