Risk Factor and Clinical Outcome of Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Stem Cell Transplantation

• Published in: Yonsei medical journal Vol. 57; no. 2; pp. 365 - 372
• Main Authors: Rhee, Chin Kook, Ha, Jick Hwan, Yoon, Jae Ho, Cho, Byung Sik, Min, Woo-Sung, Yoon, Hyoung Kyu, Lee, Jong Wook
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.03.2016; 연세대학교의과대학
• Subjects: Adult; Aged; Bronchiolitis Obliterans - epidemiology; Bronchiolitis Obliterans - etiology; Disease Progression; Female; Graft vs Host Disease - etiology; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Male; Middle Aged; Multivariate Analysis; Original; Prevalence; Proportional Hazards Models; Quality of Life; Respiratory Function Tests; Retrospective Studies; Risk Factors; Survival Analysis; Transplantation, Homologous; 의학일반; hematopoietic stem cell transplantation; Bronchiolitis obliterans syndrome; prognosis; risk factor
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2016.57.2.365

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. This retrospective study included patients who underwent allogeneic HSCT from January 2002 to December 2008 and survived for ≥100 days after transplantation. 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. 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.