Open AccessA case–control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation
Author(s) -
Nakasone Hideki,
Kanda Junya,
Yano Shingo,
Atsuta Yoshiko,
Ago Hiroatsu,
Fukuda Takahiro,
Kakihana Kazuhiko,
Adachi Tatsuya,
Yujiri Toshiaki,
Taniguchi Shuichi,
Taguchi Jun,
Morishima Yasuo,
Nagamura Tokiko,
Sakamaki Hisashi,
Mori Takehiko,
Murata Makoto
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12093
Subject(s) - medicine , bronchiolitis obliterans , busulfan , transplantation , hematopoietic stem cell transplantation , gastroenterology , risk factor , stem cell , graft versus host disease , prospective cohort study , cyclophosphamide , immunology , chemotherapy , lung transplantation , biology , genetics
Summary Bronchiolitis obliterans syndrome ( BOS ) is a significant complication after allogeneic hematopoietic stem cell transplantation ( HSCT ). However, the pathogenesis and risks for the development of BOS have remained unclear. Therefore, a case–control study was conducted to investigate the risk factors for the development of BOS , which included the largest number of BOS cases; 196 patients with BOS were identified and compared with 1960 control recipients. The following were identified as significantly higher risk factors for the development of BOS : female recipients ( OR 1.47, P = 0.019), ABO ‐mismatch HSCT (minor mismatch, OR 1.67, P = 0.015; major mismatch, OR 1.73, P = 0.012; bidirectional mismatch, OR 1.96, P = 0.018), busulfan+cyclophosphamide‐based myeloablative conditioning ( OR 1.74, P = 0.016), and acute graft‐versus‐host disease ( GVHD ) involving the skin ( OR 1.55, P = 0.011). On the other hand, the risk for the development of BOS was significantly lower in patients receiving cord blood transplantation ( OR 0.26, P = 0.0011). With respect to other target organs of chronic GVHD , ocular involvement was significantly associated with BOS ( OR 2.53, P < 0.001). Prospective studies are required to elucidate the risk factors for the development of BOS , and future investigations should focus on finding a prophylactic approach against BOS based on these findings.