Obstructive and Restrictive Lung Disease After Hematopoietic Stem Cell Transplantation

Main Article Content

Pat Arndt

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: 08 oct. 2024. doi: https://doi.org/10.18103/mra.v12i4.5156.
Section
Research Articles

References

1. Wanko S, Broadwater G, Folz R, Chao N. Diffuse alveolar hemorrhage: Retrospective review of clinical outcomes in allogeneic transplant recipients treated with aminocaproic acid. Biol Blood Marrow Transplant 2006;12: 949-953.

2. Yanik G, Hellerstedt B, Custer J, Hutchinson R, Kwon D, et al. Etanercept (Enbrel) administration for idiopathic pneumonia syndrome after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 2002;8: 395-400.

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.

25. Frankovich J, Donaldson S, Lee Y, et al. High-dose therapy and autologous hematopoietic cell transplantation in children with primary refractory and relapsed Hodgkin's disease: atopy predicts idiopathic diffuse lung injury syndromes. Biol Blood Marrow Transplant 2001;7:49–57.

26. Jagasia M, Greinix H, Arora M, et al. National Institutes of health consensus development project on criteria for clinical trials in chronic graft-versus host disease: I. The 2014 diagnosis and staging working group report. Biol Blood Marrow Transplant 2015;21:389-401.

27. Cooke K, Luzni L, Sarantopoulus S, et al. The biology of chronic graft versus-host disease: a task force report from the National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease. Biol Blood Marrow Transplant 2017;23:211-234.

28. Jamani K, He Q, Liu Y, et al. Early posttransplant spirometry is associated with the development of bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplant. Biol Bone Marrow Transplant 2020;26:943-948.

29. Kapadia M and Shapiro T. Pulmonary complications associated with HSCT. Hematopoietic stem cell transplantation for the pediatric Hematologist/Oncologist. 2018;301-325.

30. Versluys A, Rossen J, Ewijk B, et al. Strong association between respiratory viral infection early after hematopoietic stem cell transplantation and the development of life threatening acute and chronic alloimmune lung syndrome. Biol Blood Marrow Transplant 2010;16:782-791.

31. Glanville A, Benden C, Bergeron A, et al. Bronchiolitis obliterans syndrome after lung transplantation or hematopoietic stem cell transplantation: current management and future directions. ERJ Open Res 2022;8:00185.

32. Boieri M, Sha P, Dressel, et al. The role of animal models in the study of hematopoietic stem cell transplantation and GvHD: A historical overview. Frontiers in Immunol 2016;7.

33. Glanville A, Vedrleden G, Todd J, et al. Chronic lung allograft dysfunction: Definition and update of restrictive allograft syndrome- A consensus report from the pulmonary council of ISHLT. J of Heart and lung transplantation 2019;38:484-492.

34. Cheng GS, Storer B, Chien J, et al. Lung function trajectory in bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplant. Annal ATS 2015;11:1932-1939.

35. Cooke K. A “window of opportunity” for patients with late-onset pulmonary dysfunction after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 2014;20:291-292.

36. Palmer J, Williams K, Inamoto Y, et al. Pulmonary symptoms measured by the NIH lung score predict overall survival, non-relapse mortality and patient-reported outcomes in chronic GVHD. Biol Blood Marrow Transplant 2013;20:337-344.

37. Yadav H, Torghabeh M, Hogan W, et al. Prognostic significance of early declines in pulmonary function after allogeneic hematopoietic stem cell transplantation. Respiratory Care 2023;68:1406-1416.

38. Morlion B, Knoop C, Paiva M, et al. Internet-based home monitoring of pulmonary function after lung transplantation. Am J Resp Crit Care Med 2002;165:694-697.

39. Lee HJ, Kim HS, and Yoon J. Impulse oscillometry system for assessing small airway dysfunction in pediatric bronchiolitis obliterans association with conventional pulmonary function tests. PlosOne 2023;18:e0280309.

40. Sonneveld N, Rayment J, Usemann J, et al. Multiple breath washout and oscillometry after allogenic HSCT: a scoping review. Eur Resp Rev 2023;32:220251.

41. Holbro A, Lehman T, Girsberger S, et al. Lung histology predicts outcome of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Clin Res 2013;19:973-980.

42. Brugiere O, Thabut G, Mal H, et al. Exhaled NO may predict the decline in lung function in bronchiolitis obliterans. Eur Respir J 2005;25:813-819.

43. Fisher AJ, Gabbay E, Small T, Doig S, Dark JH, et al. Cross sectional study of exhaled nitric oxide levels following lung transplantation. Thorax 1998;53: 454-458.

44. Gabbay E, Walters EH, Orsida B, Whitford H, Ward C, et al. Post lung transplant bronchiolitis obliterans (BOS) is characterized by increased exhaled nitric oxide levels and epithelial nitric oxide synthetase. Am J Resp Crit Care Med 2000;162: 2182-2187.

45. Rosen J, Smith E, Scheter M, et al. Decline in 25% to 75% forced expiratory flow as an early predictor of chronic airway rejection in pediatric lung transplant recipients. J Heart Lung Transplant 2012;31:1288-1292.

46. Patterson GM, Wilson S, Whang JL, et al. Physiologic definitions of obliterative bronchiolitis in heart-lung and double lung transplantation: a comparison of the forced expiratory flow between 25% and 75% of the forced vital capacity and forced expiratory volume in one second. J Heart Lung Transplant 1996;15:175-181.

47. Bickel S, Popler J, Lesnick B, et al. Impulse oscillometry: Interpretation and practical applications. Chest 2014;146:841-847.

48. Cho E, Wu J, Birriel DC, et al. Airway oscillometry detects spirometric-silent episodes of acute cellular rejection. Am J Resp Crit Care Med 2020;201:1536-1544.

49. Oppenheimer RW, Goldring RM, Heberg ME, et al. Distal airway function in symptomatic subjects with normal spirometry following Word Trade Center dust exposure. Chest 2007;132:1275-1282.

50. Frantz S, Nihlen U, Dencker M, et al. Impulse oscillometry may be of value in detecting early manifestations of COPD. Respir Med 2012;106:1116-1123.

51. Crowhurst T, Butler J, Bussell L, et al. Impulse oscillometry versus spirometry to detect bronchiolitis obliterans syndrome in bilateral lung transplant recipients: A prospective diagnostic study. Transplantation 2024;108(4):1004-1014.

52. Kuint R, Avni S, Grisariu, et al. Forced oscillatory technique for diagnosis and monitoring of bronchiolitis obliterans syndrome following allogeneic stem cell transplantation. Eur Resp J 2022;60:1418.

53. Salvator H, Devillier P, Perez T, et al. Impulse oscillometry for monitoring lung transplant recipients: a sensitive tool for bronchiolitis obliterans diagnosis? Am J Respir Crit Care 2017;195:A2502.

54. Blin E, Perez T, Neveu R, et al. Impulse oscillometry for the diagnosis of bronchiolitis obliterans syndrome after allogeneic stem cell transplantation. American Thoracic Society International conference. 2020;A2990.

55. Lahzami S, Schoeffel RE, Pechey V, et al. Small airways function declines after allogeneic haematopoietic stem cell transplantation. Eur Respir J 2011;38:1180-188.

56. Raymet J, Sanoval R, Roden J, et al. Multiple breath washout testing to identify pulmonary chronic graft versus host disease in children after hematopoietic stem cell transplantation. Transplantation and Cellular therapy 2022;28:328e1.

57. Uhlving H, Skov L, Buchvald F, et al. Lung clearance index for early detection of pulmonary complications after allo-HSCT in children. Pediatric Pulmonology 2019;54:1029-1038.

58. Estenne M, Van Muylem A, Knoop C, et al. Detection of obliterative bronchiolitis after lung transplantation by indexes of ventilation distribution. Am J Respir Crit Cre Med 2000;162:1047-1051.

59. Nyilas S, Baumeler L, Tamm M, et al. Inert gas washout in bronchiolitis obliterans following hematopoietiuc cell transplantation. Chest 2018;154:157-168.

60. Driskel M, Horsley A, Fretwell L, et al. Lung clearance index in detection of post-transplant bronchiolitis obliterans syndrome. ERJ Open Res 2019;5:00164.

61. Reynaud-Gaubert M, Thomas P, Badier M, et al. Early detection of airway involvement in obliterative bronchiolitis after lung transplantation: Functional and bronchoalveolar lavage cell findings. Am J Resp Crit Care Med 2000;161:1924-1929.

62. Thompson B, Hodgson Y, Kotsimbos T, et al. Bronchiolitis obliterans syndrome leads to a functional deterioration of the acinus post lung transplant. Thorax 2014;69:487-488.

63. Thompson B, Ellis M, Stuart-Andrewes C, et al. Early bronchiolitis obliterans syndrome shows an abnormality of perfusion not ventilation in lung transplant recipients. Resp Physiol Neurobiol 2015;216:28-34.

64. 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.

65. Nyilas S, Baumeler L, Tamm M, et al. Inert gas washout in bronchiolitis obliterans following hematopoietic cell transplantation. Chest 2018;154:157-168.

66. Bergeron A, Belle A, Chevret S, et al. Combined inhaled steroids and bronchodilators in obstructive airway disease after allogeneic stem cell transplantation. Bone Marrow Transplant 2007;39:547-553.

67. Clark J, Crawford S, Madtes D, et al. Obstructive lung disease after allogeneic marrow transplantation. Clinical presentation and course. Ann Intern Med 1989;111:368-376.

68. Nishio N, Yagasaki H, Takahashi Y, et al. Late-onset non-infectious pulmonary complications following allogeneic hematopoietic stem cell transplantation in children. Bone Marrow Transplant 2009;44:303-308.

69. Wolff D, Reichenberger F, Steiner B, et al. Progressive interstitial fibrosis of the lung in sclerodermoid chronic graft-versus-host disease. Bone Marrow Transplantation 2002;29:357-360.

70. Williams K, Cheng GS, Pusic I, et al. FAM treatment for new onset bronchiolitis obliterans syndrome after hematopoietic cell transplantation. Biol Blood Marrow Transplant 2016;22:710-716.

71. Kim SJ, Lee JW, Jung CW, Min CK, Cho B, et al. Weekly rituximab followed by monthly rituximab treatment for steroid-refractory chronic graft-versus-host disease: results from a prospective multicenter phase II study. Haematologica 2010;95:1935-1942.

72. Watanabe S, Waseda Y, Kimura H, et al. Imatinib for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2015;50:1250-1252.

73. Del Fante C, Galasso T, Bernasconi P, Scudeller L, Ripamonti F, et al. Extracorporeal photophoresis as a new supportive therapy for bronchiolitis obliterans syndrome after allogeneic stem cell transplantation. Bone Marrow Transplant 2016;51: 728-731.

74. Kirsten M, Williams SZP, Lee S, et al. Interim analysis of a phase II trial of montelukast for the treatment of bronchiolitis obliterans syndrome after HSCT reveal immunology of disease. Biol Blood Marrow Transplant 2013;S109-S392.

75. Bergeron A, Chevret S, Chagnon K, et al. Budesonide/formoterol for bronchiolitis obliterans after hematopoietic stem cell transplantation. Am J Resp Crit Care Med 2015;191:1242-1249.

76. Norman BC, Jacobsohn DA, Williams KM, et al. Fluticasone, azithromycin and montelukast therapy in reducing corticosteroid exposure in bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: a case series of eight patients. Bone Marrow Transplant 2011;46:1369-1373.

77. Bashoura L, Gupta S, Jain A, et al. Inhaled corticosteroids stabilize constrictive bronchiolitis after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2008;41:63-67.

78. Khalid M, Al Saghir A, Saleemi S, et al. Azithromycin in bronchiolitis obliterans complicating bone marrow transplantation: a preliminary study. Eur Respir J 2005;25:490-493.

79. Masttaiou EI, Sharifi H, O’Donnell C, et al. The safety and tolerability of pirfenidone for bronchiolitis obliterans syndrome after hematopoietic cell transplant (STOP-BOS) trial. Bone Marrow Transplant 2022;57:31-326.

80. Bondeelle L, Chevret S, Hurabielle C, et al. Effect of Ruxolitinib on lung function after allogeneic stem cell transplantation. Biol Blood Marrow Transplant 2020;26:2115-2120.

81. Zhang X, Zhao X, Shen Y, et al. Ruxolitinib as an effective and steroid-sparing first-line treatment in newly diagnosed BOS patients after hematopoietic stem cell transplantation. Frontiers Pharmacol 20223;13:916472.

82. Zhao Y, OuYang G, Shi J, et al. Salvage therapy with low-dose ruxolitinib leads to a significant improvement in bronchiolitis obliterans syndrome in patients with cGVHD after allogeneic hematopoietic stem cell transplantation. Frontier Pharmacol 2021;12:668825.

83. Streiler C, Shaikh F, Davis C, et al. Ruxolitinib is an effective steroid sparing agent in bronchiolitis obliterans due to chronic graft-versus-host-disease. Bone Marrow Transplantation 2020;55:1194-1196.

84. Zeiser R, Polverelli N, Ram R, et al. Ruxolitinib for glucocorticoid-refractory chronic graft-versus-host disease. NEJM 2021;385:228-238.

85. Vogel U, Nagayama K, Bojic M, et al. Lung transplantation for bronchiolitis obliterans after allogeneic hematopoietic stem cell transplantation: a single-center experience. Transplantation 2013;95:623-628.

86. Whitson BA, Shelstad RC, Hertz MI, et al. Lung transplantation after hematopoietic stem cell transplantation. Clin Transplant 2012;26:254.

87. Rabitsch W, Deviatko E, Keil F, et al. Successful lung transplantation for bronchiolitis obliterans after allogeneic marrow transplantation. Transplantation 2001;71:1341.

88. Heath JA, Kurland G, Spray TL, et al. Lung transplantation after allogeneic marrow transplantation in pediatric patients: the Memorial Sloan-Kettering experience. Transplantation 2001;72:1986.

89. Riddell P, Vasudevan-Nampoothiri R, Ma J, et al. Lung transplantation for late-onset non-infectious chronic pulmonary complications of allogeneic hematopoietic stem cell transplant. Respir Res 2021;22:111.

90. Holm AM, Riise GC, Hansson L, Brinch L, Bjørtuft O, et al. Lung transplantation for bronchiolitis obliterans syndrome after allo-SCT. Bone Marrow Transplant 2013;48: 703-707.

91. Dharmagunawardena R, Pearce R, Thomas G, et al. A retrospective multi-centre study of the effects of allogeneic haematopoietic SCT on pulmonary function. Bone Marrow Transplant 2014;49:1442-1443.

92. Namkoong H, Ishii M, Mori T, et al. Clinical and radiological characteristics of patients with lated-onset severe restrictive lung defect after hematopoietic stem cell transplantation. BMC Pulmonary Medicine 2017;17:123-131.

93. Meignin V, Thivolet-Bejui F, Kambouchner M, et al. Lung histopathology of non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation. Histopathology 2018;73:832-842.

94. Takeuchi Y, Miyagawa-Hayashino A, Chen F, et al. Pleuroparenchymal fibroelastosis and non-specific interstitial pneumonia: frequent pulmonary sequelae of haematopoietic stem cell transplantation. Histopathology 2015;66:536-544.

95. Mariani F, Gatti B, Rocca A, et al. Pleuroparenchymal fibroelastosis: the prevalence of secondary forms in hematopoietic stem cell and lung transplantation recipients. Diagn Interv Radiol 2016;22:400-406.

96. Schlemmer F, Chevret S, Lorillon G, et al. Late-onset noninfectious interstitial lung disease after allogeneic hematopoietic stem cell transplantation. Respiratory Medicine 108:1525-1533, 2014.

97. Arora M, Chen Y, Wu J, et al. Longitudinal trajectory of frailty in blood or marrow transplant survivors: Report from the blood or marrow transplant survivor study. Cancer 2021;127:794-800.

98. Martires K, Baird K, Steinberg S, et al. Sclerotic-type chronic GVHD of the skin: clinical risk factors, laboratory markers, and burden of disease. Blood 2011;118:4250-4257.

99. Modi D, Jang H, Kim S, Deol A, Ayash L, et al. Incidence, etiology, and outcome of pleural effusions in allogeneic hematopoietic stem cell transplantation. Am J Hematol 2016;91: E341-347.

100. Leonard JT, Newell LF, Meyers G, Hayes-Lattin B, Gajewski J, et al. Chronic GvHD-associated serositis and pericarditis. Bone Marrow Transplant 2015;50: 1098-1104.

101. Ricoy J, Suarwez-Antelo J, Antunez J, et al. Pleuroparenchymal fibroelastosis: clinical, radiological, and histopathological features. Resp Med 2022;191:106437.

102. Bondeelle L, Gras J, Michonneau D, et al. Pleuroparenchymal fibroelastosis after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplantation 2020;55:982-986.

103. Beynat-Mouterde C, Beltramo G, Lezmi G, et al. Pleuroparenchymal fibroelastosis as a late complication of chemotherapy agents. Eur Respir J 2014;44:523-527.

104. Seber A, Khan S, Kersey J. Unexplained effusions: association with allogenic bone marrow transplantation and acute or chronic graft-versus-host disease. Bone Marrow Transplantation. 1996;17(2):207-211.

105. Ballal P, Arndt P, and Twaddell. Pleurodesis: A novel treatment option for refractory chronic graft versus host disease associated serositis. Chest 2017;532A.

106. Von der Thusen J, Hansell D, Tominaga M, et al. Pleuroparenchymal fibroelastosis in patients with pulmonary disease secondary to bone marrow transplantation. Modern Pathology 2011;24:1633-1639.

107. Chua F, Desai S, Nicholson A, et al. Pleureoparenchymal fibroelastosis: A review of clinical, radiological, and pathological characteristics. Ann Am Thora Soc 2019;16:1351-1359.

108. Reddy T, Tominaga M, Hansell D, et al. Pleuroparenchymal fibroelastosis: a spectrum of histopathological and imaging phenotypes. Eur Respir J 2012;40:377-385.

109. Watanabe K, Ishii H, Kiyomi F, et al. Criteria for the diagnosis of idiopathic pleuroparenchymal fibroelastosis: A proposal. Respiratory Investigation 2019;57:312-320.

110. Enomoto Y, Nakamura Y, Satake Y, et al. Clinical diagnosis of idiopathic pleuroparanchymal fibroelastosis: A retrospective multicenter study. Resp Med 2017;133:1-5.

111. Ali M, Ramalingam V, Haasler G, et al. Pleuroparenchymal fibroelastosis (PPFE) treated with lung transplantation and review of the literature. BMJ case repo 2019;12:e229402.

112. Shiiya H and Sato M. Lung transplantation for pleuroparenchymal fibroelastosis. J Clin Med 10:957-964, 2021.

113. Faccioli E, Verzeletti V, Giraudo, et al. Lung transplantation for pleuroparenchymal fibroelastosis: a single-center experience with revision of the literature. Biomedicines 2023;11:1505- 1514.