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Erschienen in: Pediatric Radiology 11/2008

01.11.2008 | Original Article

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

verfasst von: Laura Merlini, Irene Maria Olivia Borzani, Mehrak Anooshiravani, Isabelle Rochat, Ayse Hulya Ozsahin, Sylviane Hanquinet

Erschienen in: Pediatric Radiology | Ausgabe 11/2008

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Abstract

Background

Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established.

Objective

To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD).

Materials and methods

A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD.

Results

Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT.

Conclusion

The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data.
Literatur
1.
Zurück zum Zitat Eikenberry M, Bartakova H, Defor T et al (2005) Natural history of pulmonary complications in children after bone marrow transplantation. Biol Blood Marrow Transplant 11:56–64PubMedCrossRef Eikenberry M, Bartakova H, Defor T et al (2005) Natural history of pulmonary complications in children after bone marrow transplantation. Biol Blood Marrow Transplant 11:56–64PubMedCrossRef
2.
Zurück zum Zitat Griese M, Rampf U, Hofmann D et al (2000) Pulmonary complications after bone marrow transplantation in children: twenty-four years of experience in a single pediatric center. Pediatr Pulmonol 30:393–401PubMedCrossRef Griese M, Rampf U, Hofmann D et al (2000) Pulmonary complications after bone marrow transplantation in children: twenty-four years of experience in a single pediatric center. Pediatr Pulmonol 30:393–401PubMedCrossRef
3.
Zurück zum Zitat Yanik G, Cooke KR (2006) The lung as a target organ of graft-versus-host disease. Semin Hematol 43:42–52PubMedCrossRef Yanik G, Cooke KR (2006) The lung as a target organ of graft-versus-host disease. Semin Hematol 43:42–52PubMedCrossRef
4.
Zurück zum Zitat Palmas A, Tefferi A, Myers JL (1998) Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation. Br J Haematol 100:680–687PubMedCrossRef Palmas A, Tefferi A, Myers JL (1998) Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation. Br J Haematol 100:680–687PubMedCrossRef
5.
Zurück zum Zitat Afessa B, Litzow MR, Tefferi A (2001) Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplant 28:425–434PubMedCrossRef Afessa B, Litzow MR, Tefferi A (2001) Bronchiolitis obliterans and other late onset non-infectious pulmonary complications in hematopoietic stem cell transplantation. Bone Marrow Transplant 28:425–434PubMedCrossRef
6.
Zurück zum Zitat Yousem SA (1997) The histological spectrum of chronic necrotizing forms of pulmonary aspergillosis. Hum Pathol 28:650–656PubMedCrossRef Yousem SA (1997) The histological spectrum of chronic necrotizing forms of pulmonary aspergillosis. Hum Pathol 28:650–656PubMedCrossRef
7.
Zurück zum Zitat Trisolini R, Bandini G, Stanzani M et al (2001) Morphologic changes leading to bronchiolitis obliterans in a patient with delayed non-infectious lung disease after allogeneic bone marrow transplantation. Bone Marrow Transplant 28:1167–1170PubMedCrossRef Trisolini R, Bandini G, Stanzani M et al (2001) Morphologic changes leading to bronchiolitis obliterans in a patient with delayed non-infectious lung disease after allogeneic bone marrow transplantation. Bone Marrow Transplant 28:1167–1170PubMedCrossRef
8.
Zurück zum Zitat Przepiorka D, Weisdorf D, Martin P et al (1995) 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 15:825–828PubMed Przepiorka D, Weisdorf D, Martin P et al (1995) 1994 Consensus Conference on Acute GVHD Grading. Bone Marrow Transplant 15:825–828PubMed
9.
Zurück zum Zitat Austin JH, Muller NL, Friedman PJ et al (1996) Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology 200:327–331PubMed Austin JH, Muller NL, Friedman PJ et al (1996) Glossary of terms for CT of the lungs: recommendations of the Nomenclature Committee of the Fleischner Society. Radiology 200:327–331PubMed
10.
Zurück zum Zitat Clark JG, Crawford SW, Madtes DK et al (1989) Obstructive lung disease after allogeneic marrow transplantation: clinical presentation and course. Ann Intern Med 111:368–376PubMed Clark JG, Crawford SW, Madtes DK et al (1989) Obstructive lung disease after allogeneic marrow transplantation: clinical presentation and course. Ann Intern Med 111:368–376PubMed
11.
Zurück zum Zitat Sargent MA, Cairns RA, Murdoch MJ et al (1995) Obstructive lung disease in children after allogeneic bone marrow transplantation: evaluation with high-resolution CT. AJR 164:693–696PubMed Sargent MA, Cairns RA, Murdoch MJ et al (1995) Obstructive lung disease in children after allogeneic bone marrow transplantation: evaluation with high-resolution CT. AJR 164:693–696PubMed
12.
Zurück zum Zitat Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17:1359–1371PubMed Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17:1359–1371PubMed
13.
Zurück zum Zitat Gower WA, Collaco JM, Mogayzel PJ Jr (2007) Pulmonary dysfunction in pediatric hematopoietic stem cell transplant patients: non-infectious and long-term complications. Pediatr Blood Cancer 49:225–233PubMedCrossRef Gower WA, Collaco JM, Mogayzel PJ Jr (2007) Pulmonary dysfunction in pediatric hematopoietic stem cell transplant patients: non-infectious and long-term complications. Pediatr Blood Cancer 49:225–233PubMedCrossRef
14.
Zurück zum Zitat Watkins TR, Chien JW, Crawford SW (2005) Graft versus host-associated pulmonary disease and other idiopathic pulmonary complications after hematopoietic stem cell transplant. Semin Respir Crit Care Med 26:482–489PubMedCrossRef Watkins TR, Chien JW, Crawford SW (2005) Graft versus host-associated pulmonary disease and other idiopathic pulmonary complications after hematopoietic stem cell transplant. Semin Respir Crit Care Med 26:482–489PubMedCrossRef
15.
Zurück zum Zitat Clark JG, Hansen JA, Hertz MI et al (1993) NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am Rev Respir Dis 147:1601–1606PubMed Clark JG, Hansen JA, Hertz MI et al (1993) NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am Rev Respir Dis 147:1601–1606PubMed
16.
Zurück zum Zitat Ben-Abraham R, Paret G, Cohen R et al (2003) Diffuse alveolar hemorrhage following allogeneic bone marrow transplantation in children. Chest 124:660–664PubMedCrossRef Ben-Abraham R, Paret G, Cohen R et al (2003) Diffuse alveolar hemorrhage following allogeneic bone marrow transplantation in children. Chest 124:660–664PubMedCrossRef
17.
Zurück zum Zitat Dodd JD, Müller NL (2005) Bronchiolitis obliterans organizing pneumonia after bone marrow transplantation: high-resolution computed tomography findings in 4 patients. J Comput Assist Tomogr 29:540–543PubMedCrossRef Dodd JD, Müller NL (2005) Bronchiolitis obliterans organizing pneumonia after bone marrow transplantation: high-resolution computed tomography findings in 4 patients. J Comput Assist Tomogr 29:540–543PubMedCrossRef
18.
Zurück zum Zitat Flowers JR, Clunie G, Burke M et al (1992) Bronchiolitis obliterans organizing pneumonia: the clinical and radiological features of seven cases and a review of the literature. Clin Radiol 45:371–377PubMedCrossRef Flowers JR, Clunie G, Burke M et al (1992) Bronchiolitis obliterans organizing pneumonia: the clinical and radiological features of seven cases and a review of the literature. Clin Radiol 45:371–377PubMedCrossRef
19.
Zurück zum Zitat Akira M, Yamamoto S, Sakatani M (1998) Bronchiolitis obliterans organizing pneumonia manifesting as multiple large nodules or masses. AJR 170:291–295PubMed Akira M, Yamamoto S, Sakatani M (1998) Bronchiolitis obliterans organizing pneumonia manifesting as multiple large nodules or masses. AJR 170:291–295PubMed
20.
Zurück zum Zitat Levine DS, Navarro OM, Chaudry G et al (2007) Imaging the complications of bone marrow transplantation in children. Radiographics 27:307–324PubMedCrossRef Levine DS, Navarro OM, Chaudry G et al (2007) Imaging the complications of bone marrow transplantation in children. Radiographics 27:307–324PubMedCrossRef
21.
Zurück zum Zitat Kotloff RM, Ahya VN, Crawford SW (2004) Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med 170:22–48PubMedCrossRef Kotloff RM, Ahya VN, Crawford SW (2004) Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med 170:22–48PubMedCrossRef
22.
Zurück zum Zitat Yoshihara S, Yanik G, Cooke KR et al (2007) Bronchiolitis obliterans syndrome (BOS), bronchiolitis obliterans organizing pneumonia (BOOP), and other late-onset noninfectious pulmonary complications following allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 13:749–759PubMedCrossRef Yoshihara S, Yanik G, Cooke KR et al (2007) Bronchiolitis obliterans syndrome (BOS), bronchiolitis obliterans organizing pneumonia (BOOP), and other late-onset noninfectious pulmonary complications following allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 13:749–759PubMedCrossRef
23.
Zurück zum Zitat Watkins TR, Chien JW, Crawford SW (2005) Graft versus host-associated pulmonary disease and other idiopathic pulmonary complications after hematopoietic stem cell transplant. Semin Respir Crit Care Med 26:482–489PubMedCrossRef Watkins TR, Chien JW, Crawford SW (2005) Graft versus host-associated pulmonary disease and other idiopathic pulmonary complications after hematopoietic stem cell transplant. Semin Respir Crit Care Med 26:482–489PubMedCrossRef
24.
Zurück zum Zitat Patriarca F, Skert C, Sperotto A et al (2004) Incidence, outcome, and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation. Bone Marrow Transplant 33:751–758PubMedCrossRef Patriarca F, Skert C, Sperotto A et al (2004) Incidence, outcome, and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation. Bone Marrow Transplant 33:751–758PubMedCrossRef
25.
Zurück zum Zitat Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17:1359–1371PubMed Worthy SA, Flint JD, Muller NL (1997) Pulmonary complications after bone marrow transplantation: high-resolution CT and pathologic findings. Radiographics 17:1359–1371PubMed
26.
Zurück zum Zitat Mathew P, Bozeman P, Krance RA et al (1994) Bronchiolitis obliterans organizing pneumonia (BOOP) in children after allogeneic bone marrow transplantation. Bone Marrow Transplant 13:221–223PubMed Mathew P, Bozeman P, Krance RA et al (1994) Bronchiolitis obliterans organizing pneumonia (BOOP) in children after allogeneic bone marrow transplantation. Bone Marrow Transplant 13:221–223PubMed
Metadaten
Titel
Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children
verfasst von
Laura Merlini
Irene Maria Olivia Borzani
Mehrak Anooshiravani
Isabelle Rochat
Ayse Hulya Ozsahin
Sylviane Hanquinet
Publikationsdatum
01.11.2008
Verlag
Springer-Verlag
Erschienen in
Pediatric Radiology / Ausgabe 11/2008
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-008-0984-9

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