Vieira A G, Funke V A M, Nunes E C, Frare R, Pasquini R
Universidade Federal do Paraná, Curitiba, Brazil.
Bone Marrow Transplant. 2014 Jun;49(6):812-7. doi: 10.1038/bmt.2014.25. Epub 2014 Mar 10.
Bronchiolitis obliterans (BO) is a severe pulmonary complication of allo-SCT. This study evaluated the incidence of BO in patients undergoing allo-SCT in Hospital Universitário da Universidade Federal do Paraná, risk factors for developing this complication and prognostic factors for those patients who developed this entity. The study included 1286 patients transplanted between 1979 and 2009 who survived for 100 days or more. We diagnosed 53 cases of BO. The cumulative incidence was 2.9% in 1 year and 3.7% in 3 years. Among patients with chronic GVHD, the cumulative incidence at the same intervals was 8.4% and 9.9%, respectively. The median time between transplantation and diagnosis of BO was 260 days (49-3877 days). In the multivariate analysis the risk factors for BO were female donor, older recipients and acute GVHD. The main prognostic factor was the severity of pulmonary impairment. Patients who developed BO earlier than 260 days had a worse prognosis than those who did so later. At least 80% of deaths were directly related to BO.
闭塞性细支气管炎（BO）是异基因造血干细胞移植（allo - SCT）的一种严重肺部并发症。本研究评估了巴拉那联邦大学医院接受allo - SCT患者中BO的发生率、发生该并发症的危险因素以及发生该疾病患者的预后因素。该研究纳入了1979年至2009年间接受移植且存活100天或更长时间的1286例患者。我们诊断出53例BO。1年时的累积发病率为2.9%，3年时为3.7%。在患有慢性移植物抗宿主病（GVHD）的患者中，相同时间间隔的累积发病率分别为8.4%和9.9%。移植至BO诊断的中位时间为260天（49 - 3877天）。多因素分析显示，BO的危险因素为女性供体、年龄较大的受者和急性GVHD。主要的预后因素是肺损伤的严重程度。BO发生早于260天的患者预后比发生晚的患者更差。至少80%的死亡与BO直接相关。
