Non-infectious pulmonary complications after bone marrow transplantation

Khurshid, Imtiaz; Anderson, Leigh C.

doi:10.1136/pmj.78.919.257

Cited by 71 publications

(72 citation statements)

References 34 publications

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“…[7][8][9] Its aetiology remains unresolved, with potential causes including viral infections, autoimmunity and graft-vs-host disease. 6,9,10 In the four cases described in the present study, we describe a pattern of pleuroparenchymal fibroelastosis following bone marrow transplantation, as diagnosed by CT findings and histopathology. Two of the cases were part of a previous CT report of complications post bone marrow transplantation.…”

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confidence: 68%

“…4 In the early phase, these are frequently of infectious aetiology, but late-phase complications (100 days or more after transplant) are predominantly non-infectious in origin, and often are related to graft-vs-host disease in allogeneic bone marrow transplantation. [5][6][7][8] A common pattern of post bone marrow transplantation fibrosis is constrictive obliterative bronchiolitis, with airflow limitation and computed tomography (CT) changes of mosaic attenuation and air trapping. [7][8][9] Its aetiology remains unresolved, with potential causes including viral infections, autoimmunity and graft-vs-host disease.…”

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confidence: 99%

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Pleuroparenchymal fibroelastosis in patients with pulmonary disease secondary to bone marrow transplantation

et al. 2011

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This study presents four patients who underwent bone marrow transplantation and subsequently developed pleuroparenchymal fibroelastosis, hitherto reported as an idiopathic condition. All presented clinically with pneumothorax and subpleural fibrosis on high-resolution computed tomography. In addition to the expected obliterative bronchiolitis, histopathology showed coexistent subpleural changes, and the relationship of pathology in multiple anatomic compartments in post bone marrow transplantation pulmonary disease is discussed.

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confidence: 68%

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confidence: 99%

Pleuroparenchymal fibroelastosis in patients with pulmonary disease secondary to bone marrow transplantation

et al. 2011

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“…Polymorphisms that increase the risk of cGVHD might also be expected to increase the incidence of BOS. 78 Common variations in the genes encoding drug-metabolizing enzymes, drug receptors, and drug transporters may give rise to individual variability in the toxicity of chemotherapeutic drugs. 79 The role of genetic polymorphisms in the cytochrome P-450 enzyme system in the liver in transplant toxicity has not been sufficiently explored.…”

Section: Future Directionsmentioning

confidence: 99%

Genomic screening and complications of hematopoietic stem cell transplantation: has the time come?

Kallianpur

2004

Bone Marrow Transplant

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Summary:The occurrence of toxic complications following hematopoietic stem cell transplantation (HSCT) is highly variable and dependent on a multitude of host, donor, and treatment factors. The increasingly broad indications for HSCT and the need to provide this treatment option to older and/or more debilitated patients emphasizes the importance of refining our methods of predicting and ameliorating these toxicities. Late complications (occurring after day 100) also pose a threat to quality of life after HSCT. Genetic polymorphisms in key molecular pathways in the host are likely to contribute significantly to the observed variability in the development HSCT-associated complications. Hepatic veno-occlusive disease and acute lung injury, two of the most serious organ toxicities that occur, represent useful paradigms for the identification of genetic polymorphisms in enzyme systems that modulate local and systemic responses to oxidant stress during transplant conditioning therapy. Ongoing studies in this area are providing clues to the prevention of adverse clinical outcomes based on the genetic milieu. This review of studies in HSCT that explore genetic risk factors for transplant complications indicates that significant progress is being made in this rapidly evolving area. However, further large-scale clinical and translational studies are needed before genomic screening can be widely used to individualize treatment. Bone Marrow Transplantation (2005) Clinicians are continually challenged by the need to predict the responses of individual patients to potentially toxic treatments. The increasing promise of cure for patients who undergo hematopoietic stem cell transplantation (HSCT) for life-threatening disorders is overshadowed by the very real threat of short-term, often fatal, complications resulting from the transplant regimen and graft-versushost disease (GVHD). However, significant variation is observed between similarly treated individuals in the development of complications. It is an appealing concept, therefore, and one to which many clinicians now subscribe, that a significant portion of this variability has a genetic basis. Identifying important genetic variables will allow for better prediction of HSCT-related outcomes, and in the process of identifying these susceptibilities, it may also be possible to gain sufficient knowledge of the underlying pathophysiology of these toxicities to develop targeted interventions.This review will focus on genomic screening of the host for the prediction of specific complications, touching briefly on selected donor factors. Other rapidly evolving areas that are not covered include molecular genetic testing to predict graft failure and disease relapse after HSCT. The role of clinical and biochemical risk factors in the pre-transplant evaluation of HSCT candidates has also been reviewed recently in this journal. 1 Importance of context-dependent genetic effectsThe study of uncommon disease-associated mutations has been invaluable to our understanding of basic pathophy...

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“…5 The true prevalence of ALI may be underestimated in this population as many studies have not used specific criteria to diagnose ALI. 6,7 Correct diagnosis of ALI is important for delivery of optimal respiratory therapy. 8 Blood transfusion is recognized as a risk factor for ALI.…”

Section: Introductionmentioning

confidence: 99%