Interstitial pneumonitis after BMT: 15 years experience in a single institution.
Data from 311 patients with hematological malignancies who received an autologous, allogeneic or syngeneic BMT in a single institution were analyzed. Interstitial pneumonia (IPn) was observed in 58 patients. Two years actuarial probability of IPn was 26.8%. In 50% of cases CMV was detected. In 23 patients (39.7%) IPn was considered idiopathic. The median time from BMT to IPn was 63.5 (range 7-720) days. Patients submitted to allogeneic BMT had a significantly higher risk of developing IPn than patients receiving syngeneic or autologous BMT (34.1% vs 16.7% and 4.9%, respectively; p = 0.0006). Among 230 patients receiving allogeneic transplant, factors with a higher risk for IPn in univariate analysis were: age over 20 years, CML, alloimmunized donor, previous splenectomy, acute and chronic GVHD. When the analysis was restricted to patients with a CMV-associated IPn, all factors except alloimmunization maintained their significance. Multivariate analysis showed that only acute GVHD (p < 0.0001) and a diagnosis of CML (p < 0.001) in the whole group of allogeneic transplants, and acute GVHD (p < 0.001) and splenectomy (p < 0.003) in CMV-associated IPn, maintained their significance. These results are discussed within the frame work of the clinical application of BMT.
Grañena
A
A
Postgraduate School of Hematology Farreras Valentí, Hospital Clinic, University of Barcelona, Spain.
Carreras
E
E
Rozman
C
C
Salgado
C
C
Sierra
J
J
Algara
M
M
Rovira
M
M
Valls
A
A
D000293:Adolescent; D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000150:complications / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000150:complications / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000628:therapy*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011658:Pulmonary Fibrosis / Q000150:complications / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous