Faculty Collaboration Database

Risk factors for interstitial pneumonia following bone marrow transplantation for severe aplastic anaemia. Br J Haematol 1989 Apr;71(4):535-43

Date

04/01/1989

Pubmed ID

2653409

DOI

10.1111/j.1365-2141.1989.tb06314.x

Scopus ID

2-s2.0-0024477284 (requires institutional sign-in at Scopus site)   60 Citations

Abstract

Data from 547 patients with aplastic anaemia who received bone marrow transplants from HLA-identical siblings were analysed to determine factors associated with the risk of interstitial pneumonia (IPn). IPn developed in 92 patients (17%). 37% of cases were associated with cytomegalovirus infection and 22% with other organisms; in 41% of cases no organism was identified. The case fatality rate was 64%; the mortality rate due to IPn was 11%. In multivariate analysis, four factors were associated with an increased probability of interstitial pneumonia: use of methotrexate rather than cyclosporine after transplantation (relative risk, 2.8; P less than 0.0008); occurrence of moderate to severe acute graft-versus-host disease (relative risk, 2.2; P less than 0.002); inclusion of total body radiation in the pretransplant preparative regimen (relative risk 2.2, P less than 0.004); and patient age greater than 20 (relative risk 1.7, P less than 0.002). The probability of IPn ranged from 4% for patients with none of these adverse risk factors to 51% (relative risk of 13.4) for patients with all four. The incidence of IPn decreased significantly between 1978 and 1985, paralleling a decrease in the use of total body radiation pretransplant for immune suppression and methotrexate post-transplant for prophylaxis against graft-versus-host disease.

Author List

Weiner RS, Horowitz MM, Gale RP, Dicke KA, van Bekkum DW, Masaoka T, Ramsay NK, Rimm AA, Rozman C, Bortin MM

Author

Mary M. Horowitz MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anemia, Aplastic
Bone Marrow Transplantation
Child
Child, Preschool
Female
Graft vs Host Disease
Humans
Infant
Male
Methotrexate
Middle Aged
Postoperative Complications
Pulmonary Fibrosis
Radiotherapy
Risk Factors