Improvement of chronic pulmonary graft-vs-host disease manifesting as bronchiolitis obliterans organizing pneumonia following extracorporeal photopheresis

Med Oncol. 2006;23(1):125-9. doi: 10.1385/MO:23:1:125.

Abstract

Despite use of combined immunosuppressive agents, prognosis of patients developing pulmonary manifestations of chronic graft-vs-host disease (cGVHD) following allogeneic stem cell transplantation (SCT) still remains poor. We present a male patient who developed pulmonary cGVHD in the form of bronchiolitis obliterans organizing pneumonia (BOOP) following allogeneic SCT for acute myelogenous leukemia. The patient developed progressive course despite use of a combination of immunosuppressive agents including high-dose prednisone, cyclosporin-A, and mycophenolate mofetil in addition to steroid-related complications. A remarkable clinical response to extracorporeal photopheresis (ECP) was observed, allowing minimization of immunosuppressive therapy and discontinuation of cyclosporin-A. Pulmonary functions and carbon monoxide diffusion capacity (DLCO) gradually improved and stabilized, but did not return to pretransplant baseline levels.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chronic Disease
  • Cryptogenic Organizing Pneumonia / therapy*
  • Graft vs Host Disease / complications*
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Male
  • Photopheresis*
  • Transplantation, Homologous