TY - JOUR
T1 - A case-control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation
AU - Nakasone, Hideki
AU - Kanda, Junya
AU - Yano, Shingo
AU - Atsuta, Yoshiko
AU - Ago, Hiroatsu
AU - Fukuda, Takahiro
AU - Kakihana, Kazuhiko
AU - Adachi, Tatsuya
AU - Yujiri, Toshiaki
AU - Taniguchi, Shuichi
AU - Taguchi, Jun
AU - Morishima, Yasuo
AU - Nagamura, Tokiko
AU - Sakamaki, Hisashi
AU - Mori, Takehiko
AU - Murata, Makoto
PY - 2013/6
Y1 - 2013/6
N2 - Bronchiolitis obliterans syndrome (BOS) is a significant complication after allogeneic hematopoietic stem cell transplantation (HSCT). However, the pathogenesis and risks for the development of BOS have remained unclear. Therefore, a case-control study was conducted to investigate the risk factors for the development of BOS, which included the largest number of BOS cases; 196 patients with BOS were identified and compared with 1960 control recipients. The following were identified as significantly higher risk factors for the development of BOS: female recipients (OR 1.47, P = 0.019), ABO-mismatch HSCT (minor mismatch, OR 1.67, P = 0.015; major mismatch, OR 1.73, P = 0.012; bidirectional mismatch, OR 1.96, P = 0.018), busulfan+cyclophosphamide-based myeloablative conditioning (OR 1.74, P = 0.016), and acute graft-versus-host disease (GVHD) involving the skin (OR 1.55, P = 0.011). On the other hand, the risk for the development of BOS was significantly lower in patients receiving cord blood transplantation (OR 0.26, P = 0.0011). With respect to other target organs of chronic GVHD, ocular involvement was significantly associated with BOS (OR 2.53, P < 0.001). Prospective studies are required to elucidate the risk factors for the development of BOS, and future investigations should focus on finding a prophylactic approach against BOS based on these findings.
AB - Bronchiolitis obliterans syndrome (BOS) is a significant complication after allogeneic hematopoietic stem cell transplantation (HSCT). However, the pathogenesis and risks for the development of BOS have remained unclear. Therefore, a case-control study was conducted to investigate the risk factors for the development of BOS, which included the largest number of BOS cases; 196 patients with BOS were identified and compared with 1960 control recipients. The following were identified as significantly higher risk factors for the development of BOS: female recipients (OR 1.47, P = 0.019), ABO-mismatch HSCT (minor mismatch, OR 1.67, P = 0.015; major mismatch, OR 1.73, P = 0.012; bidirectional mismatch, OR 1.96, P = 0.018), busulfan+cyclophosphamide-based myeloablative conditioning (OR 1.74, P = 0.016), and acute graft-versus-host disease (GVHD) involving the skin (OR 1.55, P = 0.011). On the other hand, the risk for the development of BOS was significantly lower in patients receiving cord blood transplantation (OR 0.26, P = 0.0011). With respect to other target organs of chronic GVHD, ocular involvement was significantly associated with BOS (OR 2.53, P < 0.001). Prospective studies are required to elucidate the risk factors for the development of BOS, and future investigations should focus on finding a prophylactic approach against BOS based on these findings.
KW - ABO-mismatch
KW - allogeneic hematopoietic stem cell transplantation
KW - bronchiolitis obliterans syndrome
KW - cord blood
KW - graft-versus-host disease
UR - http://www.scopus.com/inward/record.url?scp=84877960821&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84877960821&partnerID=8YFLogxK
U2 - 10.1111/tri.12093
DO - 10.1111/tri.12093
M3 - Article
C2 - 23551210
AN - SCOPUS:84877960821
SN - 0934-0874
VL - 26
SP - 631
EP - 639
JO - Transplant International
JF - Transplant International
IS - 6
ER -