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Predictive value of bronchiolitis obliterans syndrome stage 0p in chronic graft-versus-host disease of the lung. Biol Blood Marrow Transplant 2015 Jun;21(6):1127-31

Date

02/18/2015

Pubmed ID

25687798

Pubmed Central ID

PMC4970454

DOI

10.1016/j.bbmt.2015.02.006

Scopus ID

2-s2.0-84947490863   32 Citations

Abstract

Bronchiolitis obliterans syndrome (BOS) is a significant post-transplant complication with low survival. BOS stage 0p (BOS 0p) is a parameter detected on pulmonary function tests (PFTs) after lung transplantation to identify patients at risk to develop BOS. We performed a retrospective study on 442 patients who underwent allogeneic stem cell transplant from 2007 to 2011 to evaluate whether development of BOS 0p is a risk factor in this population for BOS. Patients who met criteria for BOS 0p were significantly more likely to develop BOS (hazard ratio [HR], 3.22; P < .001). BOS 0p was significantly associated with a history of lung disease pretransplant (HR, 2.48; P = .001) and chronic graft-versus-host disease (GVHD) outside the lung post-transplant (HR, 23; P < .001). Finally, BOS 0p criteria were adequately sensitive in predicting BOS (85%), with a high negative predictive value (98%). Our findings suggest a routine PFT screening strategy with the intent of detecting BOS 0p, especially among patients with prior lung disease and who developed chronic GVHD, could suitably identify an at-risk population for the development of BOS.

Author List

Abedin S, Yanik GA, Braun T, Pawarode A, Magenau J, Goldstein SC, Levine JE, Kitko CL, Couriel DR

Author

Sameem Abedin MD Assistant Professor in the Medicine department at Medical College of Wisconsin




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

Adolescent
Adult
Aged
Bronchiolitis Obliterans
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Lung
Lung Transplantation
Male
Middle Aged
Multivariate Analysis
Myeloablative Agonists
Predictive Value of Tests
Prognosis
Respiratory Function Tests
Retrospective Studies
Risk Factors
Siblings
Survival Analysis
Transplantation Conditioning
Transplantation, Homologous
Unrelated Donors