title: Late-onset noninfectious interstitial lung disease after allogeneic hematopoietic stem cell transplantation.
abstract: BACKGROUND
  Various late-onset noninfectious pulmonary complications may occur after allogeneic hematopoietic stem cell transplantation (HSCT). Interstitial lung diseases (ILD) are often overlooked, and few data are available.
  
  
  METHODS
  We retrospectively analyzed the clinical features, pulmonary function tests, radiological features and outcomes of allogeneic HSCT recipients who were diagnosed with a noninfectious ILD and were managed in our center between 2001 and 2010.
  
  
  RESULTS
  Forty patients were analyzed. The median time from transplant to ILD was 11.3 months. The donor hematopoietic stem cell source was peripheral blood stem cells in 75% of the cases. Seventy percent of the patients had extra-thoracic chronic graft versus host disease at ILD diagnosis. We identified two lung computed tomography (CT) scan patterns according to the predominance of ground glass opacities or alveolar consolidations. Restrictive ventilatory defect was the main pulmonary function pattern. Lung histology was available for seven patients and showed diffuse alveolar damage, non-specific interstitial pneumonia, organizing pneumonia or lymphoid interstitial pneumonia. Thirty-five patients (87.5%) were treated with systemic steroids. Thirteen patients died (32.5%), 10 of respiratory failure. The median survival rate at 24 months was 61%.
  
  
  CONCLUSIONS
  This study highlights the existence of noninfectious post-allogeneic HSCT ILD and provides new insights into the characteristics of these illnesses.
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, AP-HP, Hôpital Saint-Louis, Service de Pneumologie, F-75010 Paris, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Schlemmer
authors.affiliation: Biostatistics and Clinical Epidemiology Research Team (ECSTRA), UMR 1153 INSERM, Univ Paris Diderot, Sorbonne Paris Cité, France; Univ Paris Diderot, Sorbonne Paris-Cité, Département de Biostatistique et Informatique Médicale, AP-HP, Hôpital Saint Louis, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, AP-HP, Hôpital Saint-Louis, Service de Pneumologie, F-75010 Paris, France.
authors.forename: Gwenaël
authors.initials: G
authors.lastname: Lorillon
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, Service de Radiologie, AP-HP, Hôpital Saint Louis, Paris, France.
authors.forename: Cédric
authors.initials: C
authors.lastname: De Bazelaire
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, Hématologie-Greffe, APHP, Hôpital Saint-Louis, Paris, France.
authors.forename: Régis
authors.initials: R
authors.lastname: Peffault de Latour
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, Pathologie, APHP, Hôpital Saint-Louis, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Meignin
authors.affiliation: Centre Hospitalier Lyon Sud, Hématologie, Hospices Civils de Lyon, France.
authors.forename: Mauricette
authors.initials: M
authors.lastname: Michallet
authors.affiliation: Service de Thérapie Cellulaire et d'hématologie Clinique Adulte, Université d'Auvergne CREaT - EA 7283, INSERM CIC-501, CHU Clermont-Ferrand Hôpital Estaing, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Hermet
authors.affiliation: Service des Maladies Infectieuses et Tropicales, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wyplosz
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, Service des Maladies Digestives et Respiratoires de l'Enfant, AP-HP, Hôpital Robert Debré, Paris, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Houdouin
authors.affiliation: Univ François Rabelais, INSERM UMR 1100, Centre d'Etude des Pathologies Respiratoires, CHRU de Tours, Service de Pneumologie, F-37000 Tours, France.
authors.forename: Sylvain
authors.initials: S
authors.lastname: Marchand-Adam
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, Hématologie-Greffe, APHP, Hôpital Saint-Louis, Paris, France.
authors.forename: Gérard
authors.initials: G
authors.lastname: Socié
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, AP-HP, Hôpital Saint-Louis, Service de Pneumologie, F-75010 Paris, France; Biostatistics and Clinical Epidemiology Research Team (ECSTRA), UMR 1153 INSERM, Univ Paris Diderot, Sorbonne Paris Cité, France.
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Tazi
authors.affiliation: Univ Paris Diderot, Sorbonne Paris-Cité, AP-HP, Hôpital Saint-Louis, Service de Pneumologie, F-75010 Paris, France; Biostatistics and Clinical Epidemiology Research Team (ECSTRA), UMR 1153 INSERM, Univ Paris Diderot, Sorbonne Paris Cité, France. Electronic address: anne.bergeron-lafaurie@sls.aphp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Bergeron
mesh_terms: D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Bone marrow transplantation; Diffuse alveolar damage; Interstitial lung disease; Lymphoid interstitial pneumonia; Nonspecific interstitial lung pneumonia; Organizing pneumonia