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Improvement in bronchiolitis obliterans organizing pneumonia in a child after allogeneic bone marrow transplantation by a combination of oral prednisolone and low dose erythromycin

Bone Marrow Transplantation volume 26, pages 907–910 (2000)Cite this article

Abstract

We report a 13-year-old boy who developed dyspnea at rest 1 year after the occurrence of cGVHD following an allogeneic bone marrow transplant (BMT). Pulmonary function data, imaging studies, lung biopsy, and bronchoalveolar lavage were consistent with the diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP). Although reports suggest that oral methylprednisolone or methylprednisolone pulse therapies improve BOOP after BMT, we treated our patient with a combination of oral prednisolone (1 mg/kg) and low dose erythromycin (10 mg/kg) to avoid the side-effects of high-dose steroids. With this therapy, our patient showed clinical and radiological improvements within 1 week. The steroids were tapered off 12 months later and erythromycin was given for 14 months. We conclude that therapy consisting of a combination of oral prednisolone and low-dose erythromycin for BOOP after BMT may minimize the dose and duration of steroid use. Bone Marrow Transplantation (2000) 26, 907–910.

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References

  1. Krowka MJ, Rosenow EC, Hoagland HC . Pulmonary complications of bone marrow transplantation Chest 1985 87: 237–246

    Article  CAS  Google Scholar 

  2. Cordonnier C, Bernaudin FJ, Bierling P et al. Pulmonary complications occurring after allogeneic bone marrow transplantation: a study of 130 consecutive transplanted patients Cancer 1986 58: 1047–1054

    Article  CAS  Google Scholar 

  3. Chan CK, Hyland RH, Hutcheon MA . Pulmonary complications following bone marrow transplantation Clin Chest Med 1990 11: 323–332

    CAS  PubMed  Google Scholar 

  4. Noble PW . The pulmonary complications of bone marrow transplantation in adults West J Med 1989 150: 443–449

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Hamilton PJ, Pearson ADJ . Bone marrow transplantation and lung Thorax 1986 41: 497–502

    Article  CAS  Google Scholar 

  6. Mukae H, Kadota J, Kohno S et al. Increase of activated T-cells in BAL fluid of Japanese patients with bronchiolitis obliterans organizing pneumonia and chronic eosinophilic pneumonia Chest 1995 108: 123–128

    Article  CAS  Google Scholar 

  7. Palmas A, Tefferi A, Myers JL et al. Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation Br J Haematol 1998 100: 680–687

    Article  CAS  Google Scholar 

  8. Gary RE . Bronchiolitis obliterans organizing pneumonia Blood 1995 10: 65–77

    Google Scholar 

  9. Kleinau I, Peretz-Canto A, Schmid HJ et al. Bronchiolitis obliterans organizing pneumonia and chronic graft-versus-host disease in a child after allogeneic bone marrow transplantation Bone Marrow Transplant 1997 19: 841–844

    Article  CAS  Google Scholar 

  10. Ichikawa Y, Ninomiya H, Katsuki M et al. Low-dose/ long-term erythromycin for treatment of bronchiolitis obliterans organizing pneumonia (BOOP) Kurume Med J 1993 40: 65–67

    Article  CAS  Google Scholar 

  11. Ichikawa Y, Ninomiya H, Katsuki M et al. Erythromycin reduces neutrophils and neutrophil-derived elastolytic-like activity in the lower respiratory tract of bronchiolitis patients Am Rev Respir Dis 1992 146: 196–203

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Pediatric Hematology-Oncology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    T Ishii, A Manabe, Y Ebihara, T Ueda, H Yoshino, T Mitsui, H Hisakawa, H Yagasaki, A Kikuchi, T Yoshimasu, R Tanaka, T Nakahata, S Asano & K Tsuji

  2. Department of Cell Transfusion, Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    T Ishii & S Asano

  3. Department of Infectious Disease, Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    T Takahashi

  4. Department of Pathology, Institute of Medical Science, The University of Tokyo, Tokyo, Japan

    A Masunaga

  5. Department of Pediatrics, Dokkyo Medical School, Tochigi, Japan

    K-I Sugita

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  1. T Ishii
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  15. T Nakahata
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Ishii, T., Manabe, A., Ebihara, Y. et al. Improvement in bronchiolitis obliterans organizing pneumonia in a child after allogeneic bone marrow transplantation by a combination of oral prednisolone and low dose erythromycin. Bone Marrow Transplant 26, 907–910 (2000). https://doi.org/10.1038/sj.bmt.1702642

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  • DOI: https://doi.org/10.1038/sj.bmt.1702642

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