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Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation.
Biol Blood Marrow Transplant 2015; 21(3):531-8BB

Abstract

Bronchiolitis obliterans (BO) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Lung biopsy is the gold standard for diagnosis. This study describes the course of BO and assesses the congruity between biopsy-verified BO and a modified version of the National Institutes of Health's consensus criteria for BO syndrome (BOS) based exclusively on noninvasive measures. We included 44 patients transplanted between 2000 and 2010 who underwent lung biopsy for suspected BO. Of those, 23 were diagnosed with BO and 21 presented other noninfectious pulmonary pathologies, such as cryptogenic organizing pneumonia, diffuse alveolar damage, interstitial pneumonia, and nonspecific interstitial fibrosis. Compared with patients with other noninfectious pulmonary pathologies, BO patients had significantly lower values of forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, and maximal mid-expiratory flow throughout follow-up, but there was no difference in the change in pulmonary function from the time of lung biopsy. The BO diagnosis was not associated with poorer overall survival. Fifty-two percent of patients with biopsy-verified BO and 24% of patients with other noninfectious pulmonary pathology fulfilled the BOS criteria. Pathological BO diagnosis was not superior to BOS criteria in predicting decrease in pulmonary function beyond the time of biopsy. A lung biopsy may provide a characterization of pathological patterns that can extend our knowledge on the pathophysiology of HSCT-related lung diseases.

Authors+Show Affiliations

Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Institute for Inflammation Research, The Finsen Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Research Unit Women's and Children's Health, The Juliane Marie Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: hilde.hylland@gmail.com.Department of Pathology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.The Finsen Laboratory & Biotech Research and Innovation Center (BRIC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Pediatric Pulmonary Service, Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Pediatric Pulmonary Service, Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Microbiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Hematology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark; Institute for Inflammation Research, The Finsen Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25498923

Citation

Uhlving, Hilde Hylland, et al. "Biopsy-verified Bronchiolitis Obliterans and Other Noninfectious Lung Pathologies After Allogeneic Hematopoietic Stem Cell Transplantation." Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, vol. 21, no. 3, 2015, pp. 531-8.
Uhlving HH, Andersen CB, Christensen IJ, et al. Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2015;21(3):531-8.
Uhlving, H. H., Andersen, C. B., Christensen, I. J., Gormsen, M., Pedersen, K. D., Buchvald, F., ... Müller, K. G. (2015). Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation. Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation, 21(3), pp. 531-8. doi:10.1016/j.bbmt.2014.12.004.
Uhlving HH, et al. Biopsy-verified Bronchiolitis Obliterans and Other Noninfectious Lung Pathologies After Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant. 2015;21(3):531-8. PubMed PMID: 25498923.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation. AU - Uhlving,Hilde Hylland, AU - Andersen,Claus B, AU - Christensen,Ib Jarle, AU - Gormsen,Magdalena, AU - Pedersen,Karen Damgaard, AU - Buchvald,Frederik, AU - Heilmann,Carsten, AU - Nielsen,Kim Gjerum, AU - Mortensen,Jann, AU - Moser,Claus, AU - Sengeløv,Henrik, AU - Müller,Klaus Gottlob, Y1 - 2014/12/09/ PY - 2014/08/25/received PY - 2014/12/01/accepted PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/10/27/medline KW - Bronchiolitis obliterans KW - Bronchiolitis obliterans syndrome KW - Chronic graft-versus-host disease KW - Hematopoietic stem cell transplantation KW - Pulmonary function tests KW - Pulmonary pathology SP - 531 EP - 8 JF - Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation JO - Biol. Blood Marrow Transplant. VL - 21 IS - 3 N2 - Bronchiolitis obliterans (BO) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Lung biopsy is the gold standard for diagnosis. This study describes the course of BO and assesses the congruity between biopsy-verified BO and a modified version of the National Institutes of Health's consensus criteria for BO syndrome (BOS) based exclusively on noninvasive measures. We included 44 patients transplanted between 2000 and 2010 who underwent lung biopsy for suspected BO. Of those, 23 were diagnosed with BO and 21 presented other noninfectious pulmonary pathologies, such as cryptogenic organizing pneumonia, diffuse alveolar damage, interstitial pneumonia, and nonspecific interstitial fibrosis. Compared with patients with other noninfectious pulmonary pathologies, BO patients had significantly lower values of forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity, and maximal mid-expiratory flow throughout follow-up, but there was no difference in the change in pulmonary function from the time of lung biopsy. The BO diagnosis was not associated with poorer overall survival. Fifty-two percent of patients with biopsy-verified BO and 24% of patients with other noninfectious pulmonary pathology fulfilled the BOS criteria. Pathological BO diagnosis was not superior to BOS criteria in predicting decrease in pulmonary function beyond the time of biopsy. A lung biopsy may provide a characterization of pathological patterns that can extend our knowledge on the pathophysiology of HSCT-related lung diseases. SN - 1523-6536 UR - https://www.unboundmedicine.com/medline/citation/25498923/Biopsy_verified_bronchiolitis_obliterans_and_other_noninfectious_lung_pathologies_after_allogeneic_hematopoietic_stem_cell_transplantation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1083-8791(14)01397-4 DB - PRIME DP - Unbound Medicine ER -