title: Outcome and treatment of late-onset noninfectious pulmonary complications after allogeneic haematopoietic SCT.
abstract: Late-onset noninfectious pulmonary complications (LONIPCs) are life threatening for allogeneic hematopoietic SCT (allo-HSCT) recipients. However, the impact of LONIPCs on survival has not been properly evaluated and little is known about treatment efficacy. We retrospectively investigated 290 allo-HSCT recipients in our institute and reviewed the clinical aspects of 44 patients who had been diagnosed with LONIPCs. LONIPCs were significantly associated with higher rates of chronic GVHD (P<0001) and nonrelapse mortality (P=0.013), and lower rates of relapse (P=0.009). As a result of these effects, OS was significantly worse in those with LONIPCs (P=0.003). This result differs from a previous report. We then assessed short-term treatment response and final outcome. These results were defined by radiological findings, subjective symptoms, oxygen requirement and survival. Use of inhaled and systemic steroids did not affect either short-term response or final outcomes. However, administration of systemic corticosteroids earlier than at 21 days (median interval of time from onset of symptoms to systemic corticosteroids administration) was associated with a better outcome (P=0.054 for short-term response, and 0.016 for final outcome). Our study indicates that LONIPCs reduce OS, and early intervention with systemic corticosteroids may be effective.
authors.affiliation: Department of Hematology and Oncology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Watadani
authors.forename: E
authors.initials: E
authors.lastname: Maeda
authors.forename: S
authors.initials: S
authors.lastname: Ota
authors.forename: K
authors.initials: K
authors.lastname: Kataoka
authors.forename: S
authors.initials: S
authors.lastname: Seo
authors.forename: K
authors.initials: K
authors.lastname: Kumano
authors.forename: A
authors.initials: A
authors.lastname: Hangaishi
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: Y
authors.initials: Y
authors.lastname: Imai
authors.forename: K
authors.initials: K
authors.lastname: Ohtomo
authors.forename: M
authors.initials: M
authors.lastname: Fukayama
authors.forename: Y
authors.initials: Y
authors.lastname: Nannya
authors.forename: M
authors.initials: M
authors.lastname: Kurokawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult