title: Predictive value of bronchiolitis obliterans syndrome stage 0p in chronic graft-versus-host disease of the lung.
abstract: Bronchiolitis obliterans syndrome (BOS) is a significant post-transplant complication with low survival. BOS stage 0p (BOS 0p) is a parameter detected on pulmonary function tests (PFTs) after lung transplantation to identify patients at risk to develop BOS. We performed a retrospective study on 442 patients who underwent allogeneic stem cell transplant from 2007 to 2011 to evaluate whether development of BOS 0p is a risk factor in this population for BOS. Patients who met criteria for BOS 0p were significantly more likely to develop BOS (hazard ratio [HR], 3.22; P < .001). BOS 0p was significantly associated with a history of lung disease pretransplant (HR, 2.48; P = .001) and chronic graft-versus-host disease (GVHD) outside the lung post-transplant (HR, 23; P < .001). Finally, BOS 0p criteria were adequately sensitive in predicting BOS (85%), with a high negative predictive value (98%). Our findings suggest a routine PFT screening strategy with the intent of detecting BOS 0p, especially among patients with prior lung disease and who developed chronic GVHD, could suitably identify an at-risk population for the development of BOS.
authors: Division of Hematology/Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Electronic address: sameem.abedin@northwestern.edu.
authors: Sameem
authors: S
authors: Abedin
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Gregory A
authors: GA
authors: Yanik
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Thomas
authors: T
authors: Braun
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Attaphol
authors: A
authors: Pawarode
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: John
authors: J
authors: Magenau
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Steven C
authors: SC
authors: Goldstein
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: John E
authors: JE
authors: Levine
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Carrie L
authors: CL
authors: Kitko
authors: Blood and Marrow Transplant Program, University of Michigan Health System, Ann Arbor, Michigan.
authors: Daniel R
authors: DR
authors: Couriel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008168:Lung / Q000187:drug effects / Q000276:immunology / Q000473:pathology / Q000601:surgery; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019653:Myeloablative Agonists / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011379:Prognosis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D035781:Siblings; D016019:Survival Analysis; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D061349:Unrelated Donors
chemical_list: D019653:Myeloablative Agonists
keywords: BOS 0p; Bronchiolitis obliterans syndrome; Chronic GVHD