Successful Lung Transplantation for Bronchiolitis Obliterans After Allogeneic Marrow Transplantation

Rabitsch, Werner; Deviatko, Elena; Keil, Felix; Herold, C.; Dekan, Gerhard; Greinix, Hildegard; Lechner, Klaus; Klepetko, Walter; Kalhs, Peter

doi:10.1097/00007890-200105150-00028

Cited by 53 publications

(23 citation statements)

References 12 publications

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“…Intriguingly, ibrutinib treatment beginning on day 28 after HSCT in mice with established cGVHD resulted in resolution of fibrosis, suggesting that treatment in the early phase of cGVHD can permit tissue repair and further suggesting that ongoing antibody deposition in cGVHD target organs may be required for a persistent fibrogenic process. Notably, for patients with debilitating cGVHD from fibrosis, therapies include supportive care, high-dose steroids, rapamycin, mycophenolate, imatinib, extracorporal photopheresis, IL-2, and lung transplant, all with incomplete efficacy and potentially serious complications (43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55). Although conclusions from rodent cGVHD must be validated in patients, our studies collectively indicate that a wide spectrum of cGVHD patients may benefit from ibrutinib therapy.…”

Section: Discussionmentioning

confidence: 79%

Ibrutinib treatment ameliorates murine chronic graft-versus-host disease

et al. 2014

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Section: Discussionmentioning

confidence: 79%

Ibrutinib treatment ameliorates murine chronic graft-versus-host disease

et al. 2014

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“…However, most observational studies would indicate that BO has a relative poor prognosis and that progression of lung function impairment is seen in the majority of patients. [6][7][8][9]21 Secondly, since biopsies were not performed in these children, we cannot confirm absolutely the diagnosis of BO. Based on this suggestive clinical scenarion, we can state that paediatric patients with this cluster of symptoms have a high rate of response to pulse steroid therapy.…”

Section: Discussionmentioning

confidence: 99%

High-dose corticosteroid therapy for bronchiolitis obliterans after bone marrow transplantation in children

Ratjen

Rjabko

Kremens

2005

Bone Marrow Transplant

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Summary:Bronchiolitis obliterans (BO) is a rare but serious complication of paediatric allogenic bone marrow transplantation (BMT). Currently, there is no clear evidence that therapeutic interventions have a positive impact on the course of the disease. We here report our experience with high-dose pulse methylprednisolone therapy in children after BMT. Nine patients fulfilling clinical and radiologic signs of BO were included in this analysis. The total amount of treatment cycles with pulse methylprednisolone therapy ranged from 1 to 6 cycles (median four cycles). Oxygen saturation increased significantly with normalization of oxygen saturation at the end of therapy in all individuals. Normal oxygen saturation was maintained in all but one patient during follow-up (mean follow-up period 42 {plus/minus} 20 months, range 19-67 months). Forced expiratory volume in 1 s (FEV1) was within the normal range prior BMT and significantly diminished at the time of BO diagnosis. Treatment led to stabilization of lung function, with a significant improvement of FEV1 after 2 months. In all, 7/9 patients remained in clinically stable condition without further deterioration of lung function during follow-up. These data would suggest that anti-inflammatory therapy may be a valuable treatment option in paediatric patients with bronchiolitis obliterans after BMT. Bone Marrow Transplantation (2005) 36, 135-138.

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“…Some patients may be considered for lung transplantation. There are a few reports of lung transplantation in patients with advanced BO with encouraging results [103][104][105][106][107][108][109]. In a review of nine patients who underwent such treatment, five patients had single lung transplantation, and four had double lung transplantation.…”

Section: Managementmentioning

confidence: 99%

Bronchiolitis obliterans following haematopoietic stem cell transplantation

Soubani

Uberti²

2007

Eur Respir J

111

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The aim of the present article is to review the available clinical data on bronchiolitis obliterans following haematopoietic stem cell transplantation (HSCT).The data sources used were the Medline database and references from the identified articles related to bronchiolitis obliterans, noninfectious pulmonary complications and HSCT.HSCT is an important treatment for a variety of malignant and nonmalignant conditions. However, the procedure is limited by significant complications that may involve every organ of the body. Pulmonary complications are seen in 40-60% of HSCT recipients. The recent advances in prophylaxis and treatment of infectious complications have increased the significance of late noninfectious pulmonary conditions.Currently, bronchiolitis obliterans is one of the most challenging pulmonary complications facing clinicians who are taking care of haematopoietic stem cell transplantation recipients. This article reviews the clinical and pathological features of this condition, sheds some light on potential mechanisms of pathogenesis, and discusses the available management options.

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Successful Lung Transplantation for Bronchiolitis Obliterans After Allogeneic Marrow Transplantation

Abstract: This case illustrates that lung transplantation could be a therapeutic option in selected patients with BO after allogeneic BMT that is associated with extensive chronic GVHD and who are refractory to conventional immunosuppressive therapy.

Cited by 53 publications

References 12 publications

Ibrutinib treatment ameliorates murine chronic graft-versus-host disease

Ibrutinib treatment ameliorates murine chronic graft-versus-host disease

High-dose corticosteroid therapy for bronchiolitis obliterans after bone marrow transplantation in children

Bronchiolitis obliterans following haematopoietic stem cell transplantation

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