Abstract
Introduction:
Graft-Versus-Host Disease (GVHD) of the skin and gut are relatively common following allogeneic transplant for haematological malignancies but GVHD affecting the lung can be subtle.
In this study, we evaluated patients who developed lung GVHD post stem cell transplant (SCT) to determine early warning signs and response to treatment.
Method:
Patients undergoing SCT for haematological malignancies were monitored with serial pulmonary function (PFT). Symptoms of increased breathlessness (SOB) or fall in PFT prompted investigation with high resolution CT scan(HRCT).
Results:
11 patients developed lung GVHD following allogeneic SCT for lymphoma (n=7) or leukaemia (n=4). 6 had adjuvant chemotherapy, and 7 total body irradiation. 10 had exertional SOB. 3 developed pulmonary GVHD within 1 year of SCT.
PFT changes are shown.
All patients had mosaicism with gas trapping on HRCT at diagnosis, and were commenced on steroids, with 6 having other immunosuppressants.
The post-treatment HRCT showed clearance in 10 patients (1 died due to relapse of malignancy).
Conclusion:
Exertional SOB and changes in PFT are important early indicators of developing GVHD which can be confirmed on HRCT. Treatment with with immunosuppressants results in successful resolution in the majority, particularly in those who were diagnosed early in the course of this complication.
- © 2012 ERS
