TY - JOUR T1 - Obliterative bronchiolitis in haematopoietic stem cell transplantation: can it be treated? JF - European Respiratory Journal JO - Eur Respir J SP - 402 LP - 405 DO - 10.1183/09031936.05.00146604 VL - 25 IS - 3 AU - D. H. Bryant Y1 - 2005/03/01 UR - http://erj.ersjournals.com/content/25/3/402.abstract N2 - Allogeneic and autologous haematopoietic stem cell (HSC) transplantation are now both established as principal forms of treatment for patients with acute or chronic leukaemia, aplastic anaemia and various immunodeficiency syndromes, as well as various nonhaematological malignancies and auto-immune disorders 1–3. However, major limitations to the successful use of HSC transplantation include respiratory complications and graft versus host disease. Lung dysfunction occurs in up to 50% of subjects after HSC transplantation, and pulmonary complications are among the most common causes of morbidity and mortality after this procedure 4. Obliterative bronchiolitis (OB) is the most common noninfectious respiratory complication after HSC transplantation 5, 6, and usually develops as a late complication (after the first 100 days) and at the same time as chronic graft versus host disease develops. The onset of OB is usually 6–12 months post-transplant, with the clinical severity ranging from asymptomatic to fulminant and fatal. The lack of a precise definition and uniform diagnostic criteria has led to variations in the reported incidence, between 0 and 50%, with commonly quoted figures being between 5 and 20% 7, 8. Although OB has been described after autologous HSC transplantation 9, this is a rare complication, a fact usually attributed to the absence of chronic graft versus host disease after autologous HSC transplantation. The most commonly identified risk factor for OB after HSC transplantation is chronic graft versus host disease, but other risk factors include human leukocyte antigen mismatch or use of an unrelated donor, use of busulfan or methotrexate, increased age, male sex, cigarette smoking and the presence of airflow limitation prior to transplantation 6, 8, 10. … ER -