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Post-Transplant Events

Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT

Bone Marrow Transplantation volume 48, pages 703–707 (2013)Cite this article

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Abstract

Chronic GVHD (cGVHD) associated bronchiolitis obliterans syndrome (BOS) is a serious complication after allo-SCT, and lung transplantation (LTx) may be the ultimate treatment option. To evaluate this treatment, data on all patients with LTx after allo-SCT ever performed in Sweden, Norway, Denmark and Finland were recorded and compared with survival data from the Scandiatransplant registry. In total, LTx after allo-SCT had been performed in 13 patients. Allo-SCT was done because of AML (n=6), CML (n=3), ALL (n=2), immunodeficiency (n=1) and aplastic anemia (n=1). All developed clinical cGVHD, with median interval from allo-SCT to LTx of 8.2 (0.7–16) years. Median age at LTx was 34 (16–55) years, and the median postoperative observation time was 4.2 (0.1–15) years. Two patients died, one due to septicemia, the other of relapsing leukemia, after 2 and 14 months, respectively. Four developed BOS, one of these was retransplanted. The survival did not significantly differ from the survival in matched LTx controls, being 90% 1 year and 75% 5 years after LTx compared with 85% and 68% in the controls. We therefore suggest that LTx may be considered in carefully selected patients with BOS due to cGVHD after allo-SCT.

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Acknowledgements

We thank Ulla Nyström at Scandiatransplant for help with the data from the registry and to Helen Baldoremo at the EBMT Transplant Activity Survey office for providing background data on allo-SCT.

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Authors and Affiliations

  1. Department of Respiratory Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway

    A M Holm & Ø Bjørtuft

  2. Faculty of Medicine, University of Oslo, Oslo, Norway

    A M Holm

  3. Department of Respiratory Medicine and Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden

    G C Riise

  4. Department of Respiratory Medicine, Skåne University Hospital, Lund, Sweden

    L Hansson

  5. Department of Hematology, Oslo University Hospital Rikshospitalet, Oslo, Norway

    L Brinch & Y Fløisand

  6. Medical Department B, Rigshospitalet, Copenhagen, Denmark

    M Iversen

  7. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway

    S Simonsen

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  1. A M Holm
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Correspondence to A M Holm.

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Holm, A., Riise, G., Hansson, L. et al. Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT. Bone Marrow Transplant 48, 703–707 (2013). https://doi.org/10.1038/bmt.2012.197

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