Obstructive and Restrictive Lung Disease After Hematopoietic Stem Cell Transplantation
Main Article Content
Abstract
Pulmonary complications are frequently encountered by clinicians in patients who have undergone hematopoietic stem cell transplantation and are associated with increased morbidity and mortality in these patients. Complications involving the lung are caused by both infectious and non-infectious etiologies, with non- infectious complications associated with significant long-term effect on the quality of life and can occur several years after transplantation. One manifestation of non-infectious post-transplant complication is a change in pulmonary function testing compared to pre-transplant testing. These changes can either be of an obstructive or restrictive pattern with each being associated with specific post-transplant complications. An improved understanding of obstructive and restrictive lung disease after hematopoietic stem cell transplant is necessary for both primary care physicians and specialists to recognize these diseases early in their course in order to facilitate work-up, treatment, and necessary follow-up. This review will provide an overview of obstructive and restrictive lung disease after hematopoietic stem cell transplant focusing on the etiologies, diagnosis, treatment, and outcomes. We will highlight bronchiolitis obliterans syndrome as an example of obstructive disease after transplant and will discuss pleuroparenchymal fibroelastosis as a cause for restrictive findings on pulmonary function testing. Improvements in the knowledge of the underlying etiologies and pathophysiology of obstructive and restrictive lung disease after hematopoietic stem cell transplant will allow for the identification of novel biomarkers to facilitate the diagnosis of these patients and will assist in the design of future targeted therapies to improve treatment and prognosis.
Keywords:
pulmonary complications, hematopoietic stem cell transplantation, obstructive lung disease, BOS, restrictive lung disease, serositis, PPFE
Article Details
How to Cite
ARNDT, Pat.
Obstructive and Restrictive Lung Disease After Hematopoietic Stem Cell Transplantation.
Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5156>. Date accessed: 21 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i4.5156.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Chan C, Hyland R, Hutcheon M. Pulmonary complications following bone marrow transplantation. Clin chest Med 1990;11:323-32.
4. Wah T, Moss H, Robertson R, et al. Pulmonary complications following bone marrow transplantation. Br J Radiol 2003;76:3873-379.
5. Soubani A, Miller K, Hassoun P. Pulmonary complications of bone marrow transplantation. Chest 1996;109:1066-1077.
6. Rathi NK, Tanner AR, Dinh A, Dong W, Feng L, et al. Low-, medium-, or high-dose steroids with or without aminocaproic acid in adult hematopoietic SCT patients with diffuse alveolar hemorrhage. Bone Marrow Transplant 2015;50: 420-426.
7. Martino R, Porras RP, Rabella N. Prospective study of the incidence, clinical features, and outcome of symptomatic upper and lower respiratory tract infections by respiratory viruses in adult recipients of hematopoietic stem cell transplants for hematologic malignancies. Biol Blood Marrow Transplant 2005;11: 781- 796.
8. Seo S, Renaud C, Kuypers JM, Chiu CY, Huang ML, et al. Idiopathic pneumonia syndrome after hematopoietic cell transplantation: evidence of occult infectious etiologies. Blood 2015;125: 3789-3797.
9. Neofytos D, Horn D, Anaissie E, Steinbach W, Olyaei A, et al. Epidemiology and outcomes of invasive fungal infection in adult hematopoietic stem cell transplant recipients; analysis of multicenter prospective antifungal therapy (PATH) alliance registry. Clin Inf Dis 2009;48: 265-273.
10. Auberger J, Lass-Flörl C, Ulmer H, Nogler-Semenitz E, Clausen J, et al. Significant alterations in the epidemiology and treatment outcome of invasive fungal infections in patients with hematological malignancies. Int J Hematology 2008;88: 508-515.
11. Solh M, Arat M, Cao O, et al. Late-onset non-infectious pulmonary complications in adult allogeneic hematopoietic cell transplant recipients. Transplantation 2011;91:798-803.
12. Afessa B, Litzow M, Tefferi A. Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Transplant 2001;28:425-434.
13. Gandola L, Siena S, Bregni M, et al. Prospective evaluation of pulmonary function in cancer patients treated with total body irradiation, high dose melphalan, and autologous hematopoietic stem cell transplantation. In J Radiation Biol Phyu 1990;19:743-749.
14. Kishida Y, Shingai N, Hara K, et al. Impact of lung function impairment after allogeneic hematopoietic stem cell transplantation. Scientific Reports 2022;12:14155.
15. Carpenter P, Kitko C, Elad S, et al. National Institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: V. The 2014 ancillary therapy and supportive care working group. Biol Blood Marrow Transplantation 2015;21:1167-1187.
16. Majhail N, Rizzo JD, Lee S, et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Blood Marrow Transplantation 2012;18:348-371.
17. Shantikumar S, Gower W, Abts M, et al. Pulmonary surveillance in pediatric hematopoietic stem cell transplant: A multinational multidisciplinary survey. Cancer Reports,2022;e1501.
18. Sheshadri A, Sacks N, Healey B, et al. Lung function monitoring after lung transplantation and allogeneic hematopoietic stem cell transplantation. Clin Therapeutics 2022;44:755-765.
19. Yoon J, Chun YH, Lee JW, et al. Value of screening spirometry for early diagnosis of bronchiolitis obliterans syndrome in children after allogeneic hematopoietic stem cell transplantation. J Pediatr Hematol Oncol 2015;37:e462-467.
20. Rietz H, Plummer A, Gal A. Asthma as a consequence of bone marrow transplantation. Chest 2002;122: 369-370.
21. Nakaseko C, Ozawa S, Sakzaida E, et al. Incidence risk factors and outcomes of bronchiolitis obliterans after allogeneic stem cell transplantation. Int J Hematol 2011;93:375-382.
22. Uhlving H, Mathiesen S, Buchvald F, et al. Small airways dysfunction in long-term survivors of pediatric stem cell transplantation. Ped Pulmonology 2015;50:704-712.
23. Dudek A, Mahaseth H, DeFor T, et al. Bronchiolitis obliterans in chronic graft-versus-host disease: Analysis of risk factors and treatment outcomes. Biol Blood Marrow Transplant 2003;9:657-666.
24. Paz H, Crilley P, Patchefsky A, et al. Bronchiolitis obliterans after autologous bone marrow transplantation. Chest 1992;101:775–778.
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