Air-leak syndrome in patients with non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation

We reported 5 patients who developed air-leak syndrome (ALS) including pneumothorax, pneumomediastinum and subcutaneous emphysema after allogeneic stem cell transplantation (SCT). The underlying diseases were AML (n=2), ALL (n=1), MDS (n=1), and CML (n=1). All patients received allogeneic SCT from r...

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Published inRinshō ketsueki Vol. 50; no. 1; p. 39
Main Authors Enaka, Makiko, Hagihara, Maki, Sakai, Rika, Oshima, Rika, Ito, Satomi, Motohashi, Kenji, Maruta, Atsuo, Ishigatsubo, Yoshiaki, Kanamori, Heiwa
Format Journal Article
LanguageJapanese
Published Japan 01.01.2009
Subjects
Adolescent
Fatal Outcome
Female
Graft vs Host Disease - etiology
Graft vs Host Disease - therapy
Hematologic Neoplasms - complications
Hematologic Neoplasms - therapy
Hematopoietic Stem Cell Transplantation - adverse effects
Humans
Lung Diseases - etiology
Lung Diseases - therapy
Male
Mediastinal Emphysema - etiology
Mediastinal Emphysema - therapy
Middle Aged
Pneumothorax - etiology
Pneumothorax - therapy
Subcutaneous Emphysema - etiology
Subcutaneous Emphysema - therapy
Syndrome
Transplantation, Homologous
Treatment Outcome
Young Adult
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Summary:We reported 5 patients who developed air-leak syndrome (ALS) including pneumothorax, pneumomediastinum and subcutaneous emphysema after allogeneic stem cell transplantation (SCT). The underlying diseases were AML (n=2), ALL (n=1), MDS (n=1), and CML (n=1). All patients received allogeneic SCT from related donors including 2 donors with HLA mismatch. Total body irradiation was performed as a conditioning regimen in all patients. Late-onset noninfectious pulmonary complications (LONIPC) were detected in all patients before the development of ALS. The interval from diagnosis of LONIPC to onset of ALS was 10-360 days (median, 20 days). Four of 5 patients were treated with corticosteroid for chronic graft-versus-host disease and/or LONIPC. To date, three patients have died of respiratory failure. The others are currently alive and one of these surviving patients is receiving home oxygen treatment. Physicians should be aware of this rare complication following LONIPC, because treatment of ALS is difficult in some patients.
ISSN:0485-1439
DOI:10.11406/rinketsu.50.39