title: Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options.
abstract: Bronchiolitis obliterans (BO) following allogeneic haematopoietic SCT (HSCT) is a serious complication affecting 1.7-26% of the patients, with a reported mortality rate of 21-100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology and pathogenesis is still limited. Diagnostic criteria are being developed, and will allow more uniform and comparable research activities between centres. At present, no randomised controlled trials have been completed that could demonstrate an effective treatment. Steroids in combination with other immunosuppressive drugs still constitute the backbone of the treatment strategy, and results from our and other centres suggest that monthly infusions of high-dose pulse i.v. methylprednisolone (HDPM) might stabilise the disease and hinder progression. This article provides an overview of the current evidence regarding treatment options for BO and presents the treatment results with HDPM in a paediatric national HSCT-cohort.
authors.affiliation: Paediatric Clinic, National University Hospital Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark. hilde.hylland@gmail.com
authors.forename: H H
authors.initials: HH
authors.lastname: Uhlving
authors.forename: F
authors.initials: F
authors.lastname: Buchvald
authors.forename: C J
authors.initials: CJ
authors.lastname: Heilmann
authors.forename: K G
authors.initials: KG
authors.lastname: Nielsen
authors.forename: M
authors.initials: M
authors.lastname: Gormsen
authors.forename: K G
authors.initials: KG
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001989:Bronchiolitis Obliterans / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D002648:Child; D002675:Child, Preschool; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013256:Steroids / Q000627:therapeutic use; D014184:Transplantation, Homologous
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013256:Steroids; D008775:Methylprednisolone