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- Title
A case-control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation.
- Authors
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
- Abstract
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.
- Subjects
BRONCHIOLITIS; STEM cell transplantation; CYCLOPHOSPHAMIDE; DRUG efficacy; CORD blood transplantation
- Publication
Transplant International, 2013, Vol 26, Issue 6, p631
- ISSN
0934-0874
- Publication type
Article
- DOI
10.1111/tri.12093