T-cell depletion prevents from bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia after allogeneic hematopoietic stem cell transplantation with related donors

• Published in: Haematologica (Roma) Vol. 92; no. 4; pp. 558 - 561
• Main Authors: Ditschkowski, Markus, Elmaagacli, Ahmet H, Trenschel, Rudolf, Peceny, Rudolf, Koldehoff, Michael, Schulte, Claudia, Beelen, Dietrich W
• Format: Journal Article
• Language: English
• Published: Pavia Haematologica 01-04-2007; Ferrata Storti Foundation
• Subjects: Adult; Aged; Biological and medical sciences; Bone Marrow Transplantation - adverse effects; Bronchiolitis Obliterans - etiology; Bronchiolitis Obliterans - genetics; Bronchiolitis Obliterans - immunology; Bronchiolitis Obliterans - prevention & control; Chronic obstructive pulmonary disease, asthma; Cryptogenic Organizing Pneumonia - etiology; Cryptogenic Organizing Pneumonia - genetics; Cryptogenic Organizing Pneumonia - immunology; Cryptogenic Organizing Pneumonia - prevention & control; Female; Graft vs Host Disease - etiology; Graft vs Host Disease - prevention & control; Hematologic and hematopoietic diseases; Humans; Kaplan-Meier Estimate; Lymphocyte Depletion - statistics & numerical data; Lymphocyte Transfusion; Male; Medical sciences; Middle Aged; Nod2 Signaling Adaptor Protein - genetics; Peripheral Blood Stem Cell Transplantation - adverse effects; Pneumology; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - prevention & control; Proportional Hazards Models; Respiratory Insufficiency - mortality; Retrospective Studies; Sex Factors; T-Lymphocytes - immunology; T-Lymphocytes - transplantation; Tissue Donors; Toll-Like Receptor 4 - genetics; Transplantation Conditioning - adverse effects; Transplantation, Homologous; Lung disease; Pneumonia; Hematology; Respiratory disease; Stem cell; stem cell transplantation; Related donor; Hematopoietic cell; Homograft; Prevention; Depletion; Bronchiolitis obliterans organizing pneumonia; T-Lymphocyte; Bronchus disease; Graft; Bronchiolitis obliterans
• ISSN: 0390-6078; 1592-8721
• DOI: 10.3324/haematol.10710

From the Department of bone marrow transplantation, University Hospital of Essen, Hufelandstr. 55, 45122 Essen, Germany.
Correspondence:Markus Ditschkowski, MD, University Hospital of Essen, Department of bone marrow transplantation, Hufelandstrasse 55, 45122 Essen, Germany. E-mail: markus.ditschkowski{at}uni-essen.de
Bronchiolitis obliterans (BO) and bronchiolitis obliterans organizing pneumonia (BOOP) are late-onset non-infectious pulmonary complications (LONIPCs) following allogeneic hematopoietic stem cell transplantation (HSCT). In the present study 10 of 197 conventionally prepared stem cell recipients developed BOOP after 365 days and 6 patients developed BO 333 days post-transplant. No BOOP or BO was diagnosed following T-cell depletion ( p <0.05). Chronic GVHD was ascertained in all BOOP patients and appeared significantly ( p <0,001) more frequent in the conventional transplant group. The data confirm a strong association between T-cell activity, chronic GVHD, BO and BOOP and point out the impact of T lymphocytes in the pathomechanism of BOOP.
Key words: bronchiolitis obliterans, pneumonia, stem cell transplantation.