Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation

Hilde Hylland Uhlving; Claus B Andersen; Ib Jarle Christensen; Magdalena Gormsen; Karen Damgaard Pedersen; Frederik Buchvald; Carsten Heilmann; Kim Gjerum Nielsen; Jann Mortensen; Claus Moser; Henrik Sengeløv; Klaus Gottlob Müller

doi:10.1016/j.bbmt.2014.12.004

Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation

Hilde Hylland Uhlving, Claus B Andersen, Ib Jarle Christensen, Magdalena Gormsen, Karen Damgaard Pedersen, Frederik Buchvald, Carsten Heilmann, Kim Gjerum Nielsen, Jann Mortensen, Claus Moser, Henrik Sengeløv, Klaus Gottlob Müller

28 Citations (Scopus)

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.

Original language	English
Journal	Biology of Blood and Marrow Transplantation
Volume	21
Issue number	3
Pages (from-to)	531-8
Number of pages	8
ISSN	1083-8791
DOIs	https://doi.org/10.1016/j.bbmt.2014.12.004
Publication status	Published - 1 Mar 2015

Keywords

Adolescent
Adult
Allografts
Biopsy
Bronchiolitis Obliterans
Child
Child, Preschool
Follow-Up Studies
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Infant
Lung
Middle Aged

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Uhlving, H. H., Andersen, C. B., Christensen, I. J., Gormsen, M., Pedersen, K. D., Buchvald, F., Heilmann, C., Nielsen, K. G., Mortensen, J., Moser, C., Sengeløv, H., & 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, 21(3), 531-8. https://doi.org/10.1016/j.bbmt.2014.12.004

Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation. / Uhlving, Hilde Hylland; Andersen, Claus B; Christensen, Ib Jarle et al.

In: Biology of Blood and Marrow Transplantation, Vol. 21, No. 3, 01.03.2015, p. 531-8.

Research output: Contribution to journal › Journal article › Research › peer-review

Uhlving, HH, Andersen, CB, Christensen, IJ, Gormsen, M, Pedersen, KD, Buchvald, F, Heilmann, C, Nielsen, KG, Mortensen, J , Moser, C , Sengeløv, H & Müller, KG 2015, 'Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation', Biology of Blood and Marrow Transplantation, vol. 21, no. 3, pp. 531-8. https://doi.org/10.1016/j.bbmt.2014.12.004

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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.",

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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

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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.

AB - 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.

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KW - Adult

KW - Allografts

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KW - Bronchiolitis Obliterans

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KW - Child, Preschool

KW - Follow-Up Studies

KW - Hematologic Neoplasms

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Infant

KW - Lung

KW - Middle Aged

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DO - 10.1016/j.bbmt.2014.12.004

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VL - 21

SP - 531

EP - 538

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

IS - 3

ER -

Biopsy-verified bronchiolitis obliterans and other noninfectious lung pathologies after allogeneic hematopoietic stem cell transplantation

Abstract

Keywords

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