title: Risk Factor and Clinical Outcome of Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: OBJECTIVE
  The development of bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (HSCT) deteriorates patients' quality of life. This study aimed to analyze the prevalence, clinical features, risk factors and prognostic factors of BOS.
  
  
  METHODS
  This retrospective study included patients who underwent allogeneic HSCT from January 2002 to December 2008 and survived for ≥100 days after transplantation.
  
  
  RESULTS
  Of 860 patients who survived for ≥100 days, 36 (4.2%) met the diagnostic criteria. The duration of BOS development after transplantation was 466.00 (284.00-642.75) [median (interquartile range)] days. The risk factor for the development of BOS was peripheral blood as the stem cell source with a hazard ratio (HR) of 2.550 [95% confidence interval (CI): 1.274-5.104, p=0.008]. In multivariate analysis, pretransplant FEV₁/FVC (HR: 0.956, 95% CI: 0.921-0.993, p=0.020) and time from HSCT to diagnosis of BOS (HR: 0.997, 95% CI: 0.994-0.999, p=0.009) were independent prognostic factors associated with mortality.
  
  
  CONCLUSIONS
  Peripheral blood as a stem cell source is a risk factor for the development of BOS. A decreased pretransplant FEV₁/FVC and shorter duration of time from transplantation to diagnosis of BOS are poor prognostic factors for BOS.
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Chin Kook
authors: CK
authors: Rhee
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jick Hwan
authors: JH
authors: Ha
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Jae Ho
authors: JH
authors: Yoon
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Byung Sik
authors: BS
authors: Cho
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Woo Sung
authors: WS
authors: Min
authors: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. cmcyhg@catholic.ac.kr.
authors: Hyoung Kyu
authors: HK
authors: Yoon
authors: Division of Hematology, Department of Internal Medicine, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. jwlee@catholic.ac.kr.
authors: Jong Wook
authors: JW
authors: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001989:Bronchiolitis Obliterans / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D016016:Proportional Hazards Models; D011788:Quality of Life; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014184:Transplantation, Homologous
keywords: Bronchiolitis obliterans syndrome; hematopoietic stem cell transplantation; prognosis; risk factor