RT Journal Article
SR Electronic
T1 Noninfectious lung complications after allogeneic haematopoietic stem cell transplantation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1702617
DO 10.1183/13993003.02617-2017
A1 Anne Bergeron
A1 Sylvie Chevret
A1 Régis Peffault de Latour
A1 Karine Chagnon
A1 Constance de Margerie-Mellon
A1 Frédéric Rivière
A1 Marie Robin
A1 Jean Mani
A1 Gwenael Lorillon
A1 Gérard Socié
A1 Abdellatif Tazi
YR 2018
UL http://erj.ersjournals.com/content/early/2018/03/15/13993003.02617-2017.abstract
AB Epidemiological data on late noninfectious pulmonary complications (LONIPCs) following allogeneic haematopoietic stem cell transplantation (HSCT) are derived exclusively from retrospective studies and conflicting. We aimed to evaluate prospectively their incidence, risk factors and outcomes.All consecutive patients scheduled to receive allogeneic HSCT between 2006 and 2008, at the university-teaching Saint Louis Hospital (Paris, France) were screened for inclusion. Eligible patients were those surviving at day 100. Among 243 screened patients, 198 patients were included in the analysis. The median follow-up was 72.3 months [IQR: 15.2–88.5]. Fifty-five LONIPCs were diagnosed in 43 patients. Bronchiolitis obliterans syndrome (n=22) andinterstitial lung disease (n=12) were the most common LONIPC. At 36 months after inclusion, the estimated cumulative incidence of LONIPCs was 19.8% (95% CI: 14.2–25.3%). The estimated median survival after the diagnosis of LONIPCs was 78.5 months (95% CI: 20.0-not reached). Based on a multivariable Cox model, a history of chest irradiation anytime prior to HSCT, a history of pneumonia within the 100 days post-HSCT and a low mean forced expiratory flow between 25% and 75% of forced vital capacityat day 100 were associated with the development of LONIPCs.Our data provide clues to identify patients at high risk of LONIPCs. These patients should be targeted for close monitoring to provide earlier LONIPC treatment or prophylactic treatment.Chest irradiation, pneumonia and low FEF 25–75 predict lung complications after allogenic bone marrow transplantationFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Bergeron reports personal fees from Gilead, personal fees from Merck, personal fees from Pfizer, outside the submitted work.Conflict of interest: Dr. Chevret has nothing to disclose.Conflict of interest: Dr. Chagnon reports personal fees from Astra Zeneca, outside the submitted work; .Conflict of interest: Dr. de Margerie-Mellon has nothing to disclose.Conflict of interest: Dr. Riviere has nothing to disclose.Conflict of interest: Dr. Robin has nothing to disclose.Conflict of interest: Dr. Mani has nothing to disclose.Conflict of interest: Dr. Lorillon has nothing to disclose.Conflict of interest: Dr. Socié has nothing to disclose.Conflict of interest: Dr. Tazi has nothing to disclose.Conflict of interest: Dr. Peffault de Latour reports grants and personal fees from Alexion, grants and personal fees from Novartis, grants and personal fees from Pfizer, grants from Amgen, outside the submitted work.