title: Noninfectious pulmonary complications after hematopoietic stem cell transplantation: practical approach to imaging diagnosis.
abstract: Hematopoietic stem cell transplantation (HSCT) is a widely available treatment for a variety of malignant and nonmalignant disorders. The treatment outcome is affected by the type of transplant and is limited by complications secondary to immunosuppression and treatment-related toxicity. Pulmonary complications are very common and follow a predictable timeline that reflects the immunologic status of the patient in the peritransplant period. Until recently, pulmonary complications were largely attributed to infectious causes. However, advances in diagnosis and treatment have led to a shift, and noninfectious complications have emerged as a major cause of morbidity and mortality in this population. With the increasing number of centers that perform HSCT, knowledge of posttransplant noninfectious pulmonary complications has become increasingly relevant. The basic principles of and indications for HSCT are described, and a timeline for the clinical, radiologic, and pathologic manifestations of noninfectious pulmonary complications is presented. Emphasis is given to high-resolution computed tomographic findings and the role of imaging in management of complications. A practical approach is provided to guide imaging interpretation and diagnosis of noninfectious pulmonary complications after HSCT.
authors.affiliation: From the Department of Medical Imaging, Division of Cardiothoracic Radiology (E.P., C.A.S., C.J.D.), Department of Pathology and Laboratory Medicine (M.M.G.), and Blood and Marrow Transplant Program, Department of Medicine (D.A., J.T.), Ottawa Hospital, University of Ottawa, General Campus, 501 Smyth Rd, Ottawa, ON K1H 8L6, Canada; and Department of Internal Medicine, Federal University of Paraná, Curitiba, Brazil (D.L.E.).
authors.forename: Elena
authors.initials: E
authors.lastname: Peña
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Souza
authors.forename: Dante L
authors.initials: DL
authors.lastname: Escuissato
authors.forename: Marcio M
authors.initials: MM
authors.lastname: Gomes
authors.forename: David
authors.initials: D
authors.lastname: Allan
authors.forename: Jason
authors.initials: J
authors.lastname: Tay
authors.forename: Carole J
authors.initials: CJ
authors.lastname: Dennie
mesh_terms: D001706:Biopsy; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006470:Hemorrhage / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008171:Lung Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D008232:Lymphoproliferative Disorders / Q000209:etiology; D009503:Neutropenia / Q000150:complications / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods; D019172:Transplantation Conditioning / Q000009:adverse effects
chemical_list: D007166:Immunosuppressive Agents