title: Pulmonary complications after hematopoietic stem cell transplantation.
abstract: Despite advanced effective prophylaxes, pulmonary complications still occur in a high proportion of all hematopoietic stem cell recipients, accounting for considerable morbidity and mortality. The aim of our study was to describe the causes, incidences and mortality rates secondary to pulmonary complications and risk factors of such complications following hematopoietic stem cell transplantation (HSCT). We reviewed the medical records of 287 patients who underwent either autologous or allogeneic HSCT for hematologic disorders from February 1996 to October 2003 at Samsung Medical Center (134 autografts, 153 allografts). The timing of pulmonary complications was divided into pre-engraftment, early and late period. The spectrum of pulmonary complications included infectious and non-infectious conditions. 73 of the 287 patients (25.4%) developed pulmonary complications. Among these patients, 40 (54.8%) and 29 (39.7%) had infectious and non-infectious conditions, respectively. The overall mortality rate from pulmonary complications was 28.8%. Allogeneic transplant, grade II-IV acute graft-versus-host disease (GVHD) and extensive chronic GVHD were the risk factors with statistical significance for pulmonary complications after HSCT. The mortality rates from pulmonary complications following HSCT were high, especially those of viral and fungal pneumonia, diffuse alveolar hemorrhage and idiopathic pneumonia syndrome.
authors.affiliation: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.
authors.forename: Do Hyoung
authors.initials: DH
authors.lastname: Lim
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Hong Ghi
authors.initials: HG
authors.lastname: Lee
authors.forename: Byeong-Bae
authors.initials: BB
authors.lastname: Park
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.forename: Won Sup
authors.initials: WS
authors.lastname: Oh
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ji
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Joon Oh
authors.initials: JO
authors.lastname: Park
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.forename: Won Seog
authors.initials: WS
authors.lastname: Kim
authors.forename: Chul Won
authors.initials: CW
authors.lastname: Jung
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Park
authors.forename: Young-Hyuck
authors.initials: YH
authors.lastname: Im
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Kang
authors.forename: Keunchil
authors.initials: K
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008168:Lung / Q000382:microbiology; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous