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Patterns of onset and outcome of cryptogenic organizing pneumonia after allogeneic hematopoietic stem cell transplantation

International Journal of Hematology volume 109, pages 700–710 (2019)Cite this article

Abstract

Cryptogenic organizing pneumonia (COP) after allogeneic hematopoietic stem cell transplantation (HSCT) is characterized by frequent recurrence. Few studies have examined onset and recurrence patterns of COP after HSCT. We investigated the clinical features of COP after HSCT in a single-center retrospective study including 165 consecutive patients who underwent allogeneic HSCT. Eighteen patients (11%) developed COP after HSCT. Hypoxemia and pleural effusion at the onset of COP were significantly associated with umbilical cord blood transplantation (P = 0.002 and P = 0.002, respectively). Recurrence of COP was observed in six patients and significantly associated with the presence of chronic graft-versus-host disease (cGVHD; P = 0.013) and stem cell sources other than umbilical cord blood (P = 0.038). Four patients with COP died of pulmonary failure after recurrence of COP. No patients who underwent umbilical cord blood transplantation experienced recurrence of COP. These findings suggest that the clinical features at the onset of COP may depend on stem cell sources. Moreover, both stem cell source and the absence or presence of cGVHD may affect COP recurrence, indicating the need to develop treatment strategies against COP according to stem cell source and risk of cGVHD.

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Acknowledgements

The authors thank all the physicians, nurses, and other staff who participated in the care of these patients at the Department of Hematology and Oncology, Konan Kosei Hospital.

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  1. Department of Hematology and Oncology, Konan Kosei Hospital, 137 Omatsubara, Takaya-cho, Konan, Aichi, 483-8704, Japan

    Yoshitaka Adachi, Kazutaka Ozeki, Shun Ukai, Ken Sagou, Nobuaki Fukushima & Akio Kohno

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  1. Yoshitaka Adachi
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  2. Kazutaka Ozeki
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  4. Ken Sagou
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  5. Nobuaki Fukushima
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Correspondence to Yoshitaka Adachi.

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Adachi, Y., Ozeki, K., Ukai, S. et al. Patterns of onset and outcome of cryptogenic organizing pneumonia after allogeneic hematopoietic stem cell transplantation. Int J Hematol 109, 700–710 (2019). https://doi.org/10.1007/s12185-019-02643-9

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  • DOI: https://doi.org/10.1007/s12185-019-02643-9

Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Cryptogenic organizing pneumonia
  • Umbilical cord blood transplantation
  • Recurrence
  • Graft-versus-host disease