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Clinical characteristics of late-onset interstitial pneumonia after allogeneic hematopoietic stem cell transplantation

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Abstract

Non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation (HSCT) remain fatal. In particular, information regarding late-onset interstitial lung disease predominantly including organizing pneumonia and interstitial pneumonia (IP) is limited. A retrospective nationwide survey was conducted using data collected from the Japanese transplant outcome registry database from 2005 to 2010. This study focused on patients (n = 73) with IP diagnosed after day 90 post-HSCT. A total of 69 (94.5%) patients were treated with systemic steroids, and 34 (46.6%) experienced improvement. The presence of chronic graft-versus-host disease at the onset of IP was significantly associated with non-improvement of symptoms (odds ratio [OR] 0.35). At the time of last follow-up (median, 1471 days), 26 patients were alive. Of the 47 deaths, 32 (68%) were due to IP. The 3-year overall survival (OS) and non-relapse mortality (NRM) rates were 38.8% and 51.8%, respectively. In the multivariate analysis, the predictive factors for OS were comorbidities at IP onset (hazard ratio [HR]: 2.19) and performance status (PS) score of 2–4 (HR 2.77). Furthermore, cytomegalovirus reactivation requiring early intervention (HR 2.04), PS score of 2–4 (HR 2.63), and comorbidities at IP onset (HR 2.90) were also significantly associated with increased risk of NRM.

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Data availability

The data of this study are not publicly available due to ethical restrictions that it exceeds the scope of the recipient/donor’s consent for research use in the registry.

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Acknowledgements

The authors are grateful for the assistance and cooperation of all the staff members at the following collaborating institutes: the Japan Society for Transplantation and Cellular Therapy, the Japan Marrow Donor Program, and the Japanese Data Center for Hematopoietic Cell Transplantation. The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Hematology and Oncology, Okayama University Hospital, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan

    Nobuharu Fujii

  2. Division of Hematology/Oncology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan

    Makoto Onizuka

  3. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    Takahiro Fukuda

  4. Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan

    Kazuhiro Ikegame

  5. Department of Hematology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan

    Toshiro Kawakita

  6. Hematology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan

    Hirohisa Nakamae

  7. Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Takeshi Kobayashi

  8. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    Keisuke Kataoka

  9. Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan

    Keisuke Kataoka

  10. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    Masatsugu Tanaka

  11. Department of Hematology and Oncology, Kyoto University, Kyoto, Japan

    Tadakazu Kondo

  12. Central Japan Cord Blood Bank, Seto, Japan

    Koji Kato

  13. Department of Hematology and Oncology, Miyagi Children’s Hospital, Sendai, Japan

    Atsushi Sato

  14. Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Tatsuo Ichinohe

  15. Japanese Data Center for Hematopoietic Cell Transplantation, Nagakute, Japan

    Yoshiko Atsuta

  16. Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagoya, Japan

    Yoshiko Atsuta

  17. Department of Hematology, Oita University Hospital, Oita, Japan

    Masao Ogata

  18. Department of Hematology and Oncology, Shimane University School of Medicine, Izumo, Japan

    Ritsuro Suzuki

  19. Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Hideki Nakasone

Authors
  1. Nobuharu Fujii
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  2. Makoto Onizuka
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  3. Takahiro Fukuda
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  9. Masatsugu Tanaka
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  12. Atsushi Sato
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  14. Yoshiko Atsuta
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  15. Masao Ogata
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  16. Ritsuro Suzuki
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  17. Hideki Nakasone
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Consortia

JSTCT Transplant Complications Working Group

Contributions

NF and MO contributed equally to this work. NF, MO, HN, RS, TF designed the study. MO, TF, KI, TK, HN, TK, KK, MT, TK, KK, AS, TI, YA collected the data. NF, MO, HN analyzed the data. NF, NH wrote the article.

Corresponding author

Correspondence to Nobuharu Fujii.

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The authors declare that they have no conflict of interest.

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Fujii, N., Onizuka, M., Fukuda, T. et al. Clinical characteristics of late-onset interstitial pneumonia after allogeneic hematopoietic stem cell transplantation. Int J Hematol 118, 242–251 (2023). https://doi.org/10.1007/s12185-023-03624-9

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  • DOI: https://doi.org/10.1007/s12185-023-03624-9

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