Risk factors for post-stem cell transplant sinusitis

• Published in: Bone marrow transplantation (Basingstoke) Vol. 29; no. 3; pp. 257 - 261
• Main Authors: THOMPSON, A. M, COUCH, M, ZAHURAK, M. L, JOHNSON, C, VOGELSANG, G. B
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.02.2002
• Subjects: Adult; Aged; Allergies; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Asthma; Biological and medical sciences; Bone marrow; Bone marrow transplantation; Bone marrow, stem cells transplantation. Graft versus host reaction; Chronic obstructive pulmonary disease, asthma; Computed tomography; Graft versus host disease; Graft vs Host Disease - complications; Graft-versus-host reaction; Health risks; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Immunoglobulin G; Medical records; Medical sciences; Middle Aged; Paranasal sinus; Paranasal Sinus Diseases - diagnosis; Paranasal Sinus Diseases - diagnostic imaging; Paranasal Sinuses - diagnostic imaging; Patients; Pneumology; Prognosis; Remission; Retrospective Studies; Risk analysis; Risk Factors; Signs and symptoms; Sinus; Sinuses; Sinusitis; Sinusitis - etiology; Sinusitis - prevention & control; Stem cell transplantation; Stem cells; Tobacco; Tomography, X-Ray Computed; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplants & implants; Human; Immunopathology; Radiodiagnosis; Stem cell; Hematopoietic cell; Homograft; Graft versus host reaction; Paranasal sinus; Sinusitis; Risk factor; Graft; Medical imagery; ENT disease; Complication; Paranasal sinus disease; Computerized axial tomography
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1703353

An understanding of the factors that place the post-transplant patient at increased risk for sinusitis would help identify patients likely to develop disease and possibly allow for interventions that would decrease the incidence or severity of sinus disease. This retrospective study investigates the ability of screening paranasal sinus computed tomographic scans (CTs), clinical history, and potential risk factors for sinusitis, including history of tobacco use, history of allergies or asthma, IgG level, history of sinusitis, remission status and acute graft-versus-host disease (GVHD) to predict post-transplant sinusitis. Medical records and sinus CTs of 100 allogeneic bone marrow recipients were reviewed. There was no increased risk of developing sinusitis post SCT for patients with significant disease on screening CT, symptoms at time of transplant, a history of tobacco use, asthma or allergies, low IgG level, history of sinusitis or for patients at high risk of relapse. Patients with GVHD were 4.3 times more likely than patients without GVHD to develop sinusitis post transplant (95% CI: 1.7-11.0, P = 0.002). Acute GVHD places patients at greater risk of developing sinus infections.