A call to arms: a critical need for interventions to limit pulmonary toxicity in the stem cell transplantation patient population. Curr Hematol Malig Rep 2015 Mar;10(1):8-17
Date
02/11/2015Pubmed ID
25662904DOI
10.1007/s11899-014-0244-zScopus ID
2-s2.0-84925502984 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
Noninfectious pulmonary toxicity after allogeneic hematopoietic stem cell transplantation (allo-HSCT) causes significant morbidity and mortality. Main presentations are idiopathic pneumonia syndrome (IPS) in the acute setting and bronchiolitis obliterans syndrome (BOS) and cryptogenic organizing pneumonia (COP) at later time point. While COP responds well to corticosteroids, IPS and BOS often are treatment refractory. IPS, in most cases, is rapidly fatal, whereas BOS progresses over time, resulting in chronic respiratory failure, impaired quality of life, and eventually, death. Standard second-line treatments are currently lacking, and current approaches, such as augmented T cell-directed immunosuppression, B cell depletion, TNF blockade, extracorporeal photopheresis, and tyroskine kinase inhibitor therapy, are unsatisfactory with responses in only a subset of patients. Better understanding of underlying pathophysiology hopefully results in the identification of future targets for preventive and therapeutic strategies along with an emphasis on currently underutilized rehabilitative and supportive measures.
Author List
Radhakrishnan SV, Hildebrandt GCAuthor
Sabarinath Venniyil Radhakrishnan MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Anti-Bacterial AgentsBronchiolitis Obliterans
Hematopoietic Stem Cell Transplantation
Humans
Immunologic Factors
Immunosuppressive Agents
Lung Transplantation
Pneumonia
Protein Kinase Inhibitors
Quality of Life