title: A case-control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation.
abstract: Bronchiolitis obliterans syndrome (BOS) is a significant complication after allogeneic hematopoietic stem cell transplantation (HSCT). However, the pathogenesis and risks for the development of BOS have remained unclear. Therefore, a case-control study was conducted to investigate the risk factors for the development of BOS, which included the largest number of BOS cases; 196 patients with BOS were identified and compared with 1960 control recipients. The following were identified as significantly higher risk factors for the development of BOS: female recipients (OR 1.47, P = 0.019), ABO-mismatch HSCT (minor mismatch, OR 1.67, P = 0.015; major mismatch, OR 1.73, P = 0.012; bidirectional mismatch, OR 1.96, P = 0.018), busulfan+cyclophosphamide-based myeloablative conditioning (OR 1.74, P = 0.016), and acute graft-versus-host disease (GVHD) involving the skin (OR 1.55, P = 0.011). On the other hand, the risk for the development of BOS was significantly lower in patients receiving cord blood transplantation (OR 0.26, P = 0.0011). With respect to other target organs of chronic GVHD, ocular involvement was significantly associated with BOS (OR 2.53, P < 0.001). Prospective studies are required to elucidate the risk factors for the development of BOS, and future investigations should focus on finding a prophylactic approach against BOS based on these findings.
authors.affiliation: Division of Hematology, Saitama Medical Center, Jichi Medical University, Saitama, Japan. nakasone-tky@umin.ac.jp
authors.forename: Hideki
authors.initials: H
authors.lastname: Nakasone
authors.forename: Junya
authors.initials: J
authors.lastname: Kanda
authors.forename: Shingo
authors.initials: S
authors.lastname: Yano
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Atsuta
authors.forename: Hiroatsu
authors.initials: H
authors.lastname: Ago
authors.forename: Takahiro
authors.initials: T
authors.lastname: Fukuda
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kakihana
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Adachi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yujiri
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Jun
authors.initials: J
authors.lastname: Taguchi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Morishima
authors.forename: Tokiko
authors.initials: T
authors.lastname: Nagamura
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000150:complications; D001989:Bronchiolitis Obliterans / Q000209:etiology*; D002066:Busulfan / Q000009:adverse effects; D016022:Case-Control Studies; D003520:Cyclophosphamide / Q000009:adverse effects; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects; D014184:Transplantation, Homologous / Q000009:adverse effects
chemical_list: D003520:Cyclophosphamide; D002066:Busulfan