title: Prognostic value of serum surfactant protein D level prior to transplant for the development of bronchiolitis obliterans syndrome and idiopathic pneumonia syndrome following allogeneic hematopoietic stem cell transplantation.
abstract: Bronchiolitis obliterans syndrome (BOS) and idiopathic pneumonia syndrome (IPS) cause high mortality and impaired survival after allogeneic hematopoietic stem-cell transplantation (allo-HSCT). Early recognition of patients at high risk of developing BOS/IPS may lead to improving the outcome of allo-HSCT. We retrospectively analyzed serum surfactant protein A, D (SP-A, -D) and Kerbs von Lungren 6 Ag (KL-6) levels before allo-HSCT in 56 patients who survived more than 90 days after allo-HSCT and compared values of these serum markers and other transplant factors in BOS/IPS patients with those in non-BOS/IPS patients. Five patients developed BOS and two developed IPS at a median interval of 303 and 117 days (range, 100-452 and 95-153) from transplantation. As a result of univariate analysis, pretransplant serum SP-D levels but not SP-A, KL-6 in BOS/IPS patients were significantly lower than those in non-BOS/IPS patients (P=0.03). In multivariate analysis, the patients with lower pretransplant serum SP-D level had a trend toward frequent development of BOS/IPS (P=0.08). Constitutive serum SP-D level before allo-HSCT may be a useful, noninvasive predictor for the development of BOS/IPS.
authors.affiliation: Clinical Hematology and Clinical Diagnostics, Graduate School of Medicine, Osaka City University, Abeno-ku, Osaka, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nakane
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: H
authors.initials: H
authors.lastname: Kamoi
authors.forename: H
authors.initials: H
authors.lastname: Koh
authors.forename: Y
authors.initials: Y
authors.lastname: Takeoka
authors.forename: E
authors.initials: E
authors.lastname: Sakamoto
authors.forename: H
authors.initials: H
authors.lastname: Kanashima
authors.forename: M
authors.initials: M
authors.lastname: Nakamae
authors.forename: K
authors.initials: K
authors.lastname: Ohta
authors.forename: Y
authors.initials: Y
authors.lastname: Terada
authors.forename: K-R
authors.initials: KR
authors.lastname: Koh
authors.forename: T
authors.initials: T
authors.lastname: Yamane
authors.forename: M
authors.initials: M
authors.lastname: Hino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001989:Bronchiolitis Obliterans / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood; D011014:Pneumonia / Q000209:etiology*; D011379:Prognosis; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D012189:Retrospective Studies; D013577:Syndrome; D014184:Transplantation, Homologous
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; D037662:Pulmonary Surfactant-Associated Protein A; D037663:Pulmonary Surfactant-Associated Protein D