Clinical impact of airflow obstruction after allogeneic hematopoietic stem cell transplantation

作者：Sanshiro Nakao, Shokichi Tsukamoto, Yusuke Takeda, Chikako Ohwada, Chihiro Ri, Shintaro Izumi, Yuri Kamata, Shinichiro Matsui, Asuka Shibamiya, Arata Ishii, Koji Takaishi, Kohei Takahashi, Yuki Shiko, Nagisa Oshima‐Hasegawa, Tomoya Muto, Naoya Mimura, Koutaro Yokote, Chiaki Nakaseko, Emiko Sakaida · 发表于：International Journal of Hematology · 年份：2024 · DOI：10.1007/s12185-024-03831-y · 被引用次数：2 · 研究领域：Hematopoietic Stem Cell Transplantation、Immune Cell Function and Interaction、Neutropenia and Cancer Infections

Criteria for airflow obstruction (AFO) at one year after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in pulmonary function tests (PFTs) are more stringent than the bronchiolitis obliterans syndrome (BOS) criteria of the National Institutes of Health. This single-center, retrospective cohort study evaluated the clinical impact of the AFO criteria at any time after transplantation. In 132 patients who underwent allo-HSCT from 2006 to 2016, the 2-year cumulative incidence of AFO was 35.0%, and the median time to diagnosis of AFO was 101 days after transplantation (range 35-716 days). Overall chronic graft-versus-host disease (cGVHD) incidence was significantly higher in patients with AFO than in those without AFO (80.4% vs. 47.7%, P < 0.01); notably, 37.0% of patients with AFO developed cGVHD after AFO diagnosis. AFO patients developed BOS with a 5-year cumulative incidence of 49.1% after AFO onset. The 5-year cumulative incidence of non-relapse mortality in the AFO group was higher than that in the non-AFO group (24.7% vs. 7.1%, P < 0.01). These results suggest that closely monitoring PFTs within two years after allo-HSCT, regardless of cGVHD status, is important for early detection of AFO and prevention of progression to BOS. (192words).