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Efficacy of high-dose steroids for bronchiolitis obliterans syndrome post pediatric hematopoietic stem cell transplantation.
Pediatr Transplant 2018; 22(2)PT

Abstract

BOS is the pulmonary manifestation of cGvHD post-allogeneic HSCT. Survival and treatment of this often fatal complication have not improved over the last 20 years and there is no clear standard of care. For the past 10 years, BOS was treated in our center with monthly cycles of HDPS. We reviewed the outcomes of patients with post-HSCT BOS who met the diagnostic criteria for BOS as per the NIH consensus and were treated with at least one cycle of methylprednisolone at a dose of 10-30 mg/kg/d×3 d. We collected demographic and clinical data, responses to treatment and results of pulmonary function tests at several time points. Between January 2007 and January 2014, 12 patients were treated with HDPS for post-HSCT BOS. Five patients (42%) had a good response to treatment; four patients (33%) stabilized with moderate lung disease; and three patients (25%) progressed to end-stage disease. No significant acute side effects attributable to the HDPS treatment were identified. HDPS may be an effective treatment option for all but the most severely ill patients with post-HSCT BOS.

Authors+Show Affiliations

Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.Division of Respiratory Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29417689

Citation

Even-Or, Ehud, et al. "Efficacy of High-dose Steroids for Bronchiolitis Obliterans Syndrome Post Pediatric Hematopoietic Stem Cell Transplantation." Pediatric Transplantation, vol. 22, no. 2, 2018.
Even-Or E, Ghandourah H, Ali M, et al. Efficacy of high-dose steroids for bronchiolitis obliterans syndrome post pediatric hematopoietic stem cell transplantation. Pediatr Transplant. 2018;22(2).
Even-Or, E., Ghandourah, H., Ali, M., Krueger, J., Sweezey, N. B., & Schechter, T. (2018). Efficacy of high-dose steroids for bronchiolitis obliterans syndrome post pediatric hematopoietic stem cell transplantation. Pediatric Transplantation, 22(2), doi:10.1111/petr.13155.
Even-Or E, et al. Efficacy of High-dose Steroids for Bronchiolitis Obliterans Syndrome Post Pediatric Hematopoietic Stem Cell Transplantation. Pediatr Transplant. 2018;22(2) PubMed PMID: 29417689.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of high-dose steroids for bronchiolitis obliterans syndrome post pediatric hematopoietic stem cell transplantation. AU - Even-Or,Ehud, AU - Ghandourah,Hasan, AU - Ali,Muhammad, AU - Krueger,Joerg, AU - Sweezey,Neil B, AU - Schechter,Tal, Y1 - 2018/02/07/ PY - 2017/12/30/accepted PY - 2018/2/9/pubmed PY - 2018/9/6/medline PY - 2018/2/9/entrez KW - bone marrow transplantation KW - bronchiolitis obliterans KW - corticosteroids JF - Pediatric transplantation JO - Pediatr Transplant VL - 22 IS - 2 N2 - BOS is the pulmonary manifestation of cGvHD post-allogeneic HSCT. Survival and treatment of this often fatal complication have not improved over the last 20 years and there is no clear standard of care. For the past 10 years, BOS was treated in our center with monthly cycles of HDPS. We reviewed the outcomes of patients with post-HSCT BOS who met the diagnostic criteria for BOS as per the NIH consensus and were treated with at least one cycle of methylprednisolone at a dose of 10-30 mg/kg/d×3 d. We collected demographic and clinical data, responses to treatment and results of pulmonary function tests at several time points. Between January 2007 and January 2014, 12 patients were treated with HDPS for post-HSCT BOS. Five patients (42%) had a good response to treatment; four patients (33%) stabilized with moderate lung disease; and three patients (25%) progressed to end-stage disease. No significant acute side effects attributable to the HDPS treatment were identified. HDPS may be an effective treatment option for all but the most severely ill patients with post-HSCT BOS. SN - 1399-3046 UR - https://www.unboundmedicine.com/medline/citation/29417689/Efficacy_of_high_dose_steroids_for_bronchiolitis_obliterans_syndrome_post_pediatric_hematopoietic_stem_cell_transplantation_ L2 - https://doi.org/10.1111/petr.13155 DB - PRIME DP - Unbound Medicine ER -