scholarly journals Bronchiolitis obliterans syndrome ‘endotypes’ in haematopoietic stem cell transplantation

Respirology ◽  
2019 ◽  
Vol 24 (5) ◽  
pp. 408-409
Author(s):  
Daniel C. Chambers
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Bronchiolitis Obliterans ◽  
Haematopoietic Stem Cell Transplantation ◽  
Bronchiolitis Obliterans Syndrome ◽  
Haematopoietic Stem Cell

scholarly journals Noninfectious pulmonary complications of haematopoietic stem cell transplantation

2020 ◽  
Vol 29 (156) ◽  
pp. 190119
Author(s):  
Samran Haider ◽  
Navin Durairajan ◽  
Ayman O. Soubani
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Infectious Complications ◽  
Bronchiolitis Obliterans Syndrome ◽  
Pulmonary Complications ◽  
Morbidity And Mortality ◽  
Haematopoietic Stem Cell ◽  
High Morbidity

Haematopoietic stem cell transplantation (HSCT) is an established treatment for a variety of malignant and nonmalignant conditions. Pulmonary complications, both infectious and noninfectious, are a major cause of morbidity and mortality in patients who undergo HSCT. Recent advances in prophylaxis and treatment of infectious complications has increased the significance of noninfectious pulmonary conditions. Acute lung injury associated with idiopathic pneumonia syndrome remains a major acute complication with high morbidity and mortality. On the other hand, bronchiolitis obliterans syndrome is the most challenging chronic pulmonary complication facing clinicians who are taking care of allogeneic HSCT recipients. Other noninfectious pulmonary complications following HSCT are less frequent. This review provides a clinical update of the incidence, risk factors, pathogenesis, clinical characteristics and management of the main noninfectious pulmonary complications following HSCT.

scholarly journals Successful bilateral lung transplantation and simultaneous Nuss technique correction of pectus excavatum post-allogeneic haematopoietic stem cell transplantation

2019 ◽  
Author(s):  
Zhenrong Zhang ◽  
Hao Ding ◽  
Feng Liu ◽  
Jingyu Chen
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Lung Transplantation ◽  
Bronchiolitis Obliterans ◽  
Haematopoietic Stem Cell Transplantation ◽  
Pectus Excavatum ◽  
Bronchiolitis Obliterans Syndrome ◽  
Haematopoietic Stem Cell ◽  
Bilateral Lung Transplantation ◽  
Bilateral Lung

Abstract Bronchiolitis obliterans syndrome after allogeneic haematopoietic stem cell transplantation has aroused clinical concern. We describe a case of a 39-year-old female patient diagnosed as bronchiolitis obliterans syndrome and concomitant pectus excavatum with a Haller index of 3.32. The patient received bilateral lung transplantation and simultaneously underwent Nuss surgery via bilateral anterolateral thoracotomies with veno-arterial extracorporeal membrane oxygenation support. The bar was removed 2 years after transplantation, and the patient has been stable in the past 4 years with haematological remission and satisfactory lung function.

Ventilation Heterogeneity Of Peripheral Airways (Sacin*VT) Assessed By Nitrogen Multiple Breath Washout (N2-MBW) Is An Accurate and Sensitive Marker Of Bronchiolitis Obliterans Following Haematopoietic Stem Cell Transplantation Recipients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4599-4599
Author(s):  
Federica De Giacomi ◽  
Maria Teresa Lupo-Stanghellini ◽  
Alessia Orsini ◽  
Elena Guggiari ◽  
Consuelo Corti ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Bronchiolitis Obliterans ◽  
Haematopoietic Stem Cell Transplantation ◽  
Haematopoietic Stem Cell ◽  
Small Airways ◽  
Peripheral Airways ◽  
Peripheral Airway ◽  
Multiple Breath Washout

Bronchiolitis Obliterans (BO) initially affects terminal and respiratory bronchioles, a region of the lung largely unexplored by spirometry, which is only altered in advanced disease. In contrast, the Impulse Oscillation System (IOS) and the nitrogen multiple breath washout (N2-MBW) are techniques characterized by a high sensitivity to peripheral airway changes and potentially more suited to early detection of small airways disease. In a cross sectional study, a total of 161 patients, divided into 4 groups: healthy controls (n=41), bone marrow transplant candidates (n=47), haematopoietic stem cell transplantation (HSCT) recipients (n=65) and patients with chronic obstructive pulmonary disease (COPD; n=8), were assessed by IOS, N2-MBW, spirometry, body plethysmography and diffusing capacity for carbon monoxide (DLCO) in order to describe respiratory function changes in post-transplant patients without pulmonary graft versus host disease (GVHD) and in order to characterize the pattern of peripheral airway changes in BO. All subjects were able to perform IOS and N2-MBW without difficulty. Significant variables are illustrated in the table.ControlNo BOSpBOSpMSDMSDMSDRV/TLC %9714109240.04414422<0.001DLCO %96880160.0024911<0.001Scond* VT [l]0.020.010.030.02<0.0010.020.01<0.001Sacin* VT [l]0.050.020.130.09<0.0010.370.20<0.001Z5Hz [cmH2O/(l/s)]3.070.673.491.29NS4.932.460.017DR5-20Hz [cmH2O/(l/s)]0.300.230.560.68NS1.250.960.016X5Hz [cmH2O/(l/s)]-0.950.21-1.130.77NS-2.271.980.002fR [1/s)]10.632.5413.194.86NS20.346.39<0.001Rperipheral [cmH2O/(l/s)]1.770.802.091.46NS3.703.060.026 Stem cell transplantation, even without respiratory complications, does not affect spirometry but appears to cause an increase in air trapping, a reduction in DLCO and enhanced ventilation inhomogeneity both in conductive (Scond*VT) and acinar (Sacin*VT) airways. Patients with BO (n=8) were characterized by further DLCO reduction, increase in oscillometric indices sensible to peripheral airways involvement (Z5Hz, DR5-20Hz, X5Hz, Resonant frequency and Rperipheral) and a further three-fold increase in Sacin* VT. Compared to patients with BO, COPD patients with the same degree of spirometric obstruction (FEV1/FVC< 0.7, FEV1 50% predicted) showed only half the increase in predicted Sacin*VT (p= 0.03). At a cut off of 321% of predicted value, Sacin* VT could distinguish the subjects with BO from recipients, with good accuracy (87%), sensibility (87.5%) and specificity (89.5%). We conclude that IOS and N2-MBW are simple tests able to detect changes following HSCT as well as those specific to Bronchiolitis Obliterans. Disclosures: No relevant conflicts of interest to declare.

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