A case–control study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation |
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| Authors: | Hideki Nakasone Junya Kanda Shingo Yano Yoshiko Atsuta Hiroatsu Ago Takahiro Fukuda Kazuhiko Kakihana Tatsuya Adachi Toshiaki Yujiri Shuichi Taniguchi Jun Taguchi Yasuo Morishima Tokiko Nagamura Hisashi Sakamaki Takehiko Mori Makoto Murata GVHD Working Group of the Japan Society for Hematopoietic Cell Transplantation |
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| Affiliation: | 1. Division of Hematology, Saitama Medical Center, Jichi Medical University, , Saitama, Japan;2. Division of Clinical Oncology and Hematology, Department of Internal Medicine, Jikei University School of Medicine, , Tokyo, Japan;3. Department of HSCT Data Management/Biostatistics, Nagoya University Graduate School of Medicine, , Nagoya, Japan;4. Department of Hematology and Oncology, Shimane Prefectural Central Hospital, , Shimane, Japan;5. Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, , Tokyo, Japan;6. Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, , Tokyo, Japan;7. Department of Hematology, Meitetsu Hospital, , Nagoya, Japan;8. Third Department of Internal Medicine, Yamaguchi University School of Medicine, , Yamaguchi, Japan;9. Department of Hematology, Toranomon Hospital, , Tokyo, Japan;10. Department of Hematology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, , Nagasaki, Japan;11. Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, , Nagoya, Japan;12. Department of Cell Processing and Transfusion, Institute of Medical Science, University of Tokyo, , Tokyo, Japan;13. Division of Hematology, Department of Medicine, Keio University School of Medicine, , Tokyo, Japan;14. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, , Nagoya, Japan |
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| Abstract: | 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. |
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| Keywords: | ABO‐mismatch allogeneic hematopoietic stem cell transplantation bronchiolitis obliterans syndrome cord blood graft‐versus‐host disease |
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