Ahn Jee Hwan, Jo Kyung-Wook, Song Jin Woo, Shim Tae Sun, Lee Sei Won, Lee Jae Seung, Kim Dae-Young, Lee Je-Hwan, Lee Jung-Hee, Choi Yunsuk, Lee Kyoo-Hyung
Division of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Division of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Clin Transplant. 2015 Dec;29(12):1133-9. doi: 10.1111/ctr.12638. Epub 2015 Oct 30.
Bronchiolitis obliterans syndrome (BOS) can occur after hematopoietic stem cell transplantation (HSCT) and is associated with significant mortality. We investigated the role of forced expiratory volume in one s (FEV1 ) as a prognostic marker in BOS after HSCT.
Among all patients who underwent HSCT between December 1993 and November 2013 at a tertiary center in South Korea, 1187 patients were enrolled. Patient medical records were retrospectively analyzed to evaluate the prognostic factors associated with survival in these cases.
During a median follow-up period of 30.7 months after HSCT, 82 patients (6.9%) were diagnosed with BOS. The mean FEV1 of the BOS patients was 34.7% of predicted, and the mean FEV1 of 31 of these patients (37.8%) was <30% of predicted. The estimated overall survival rate for BOS patients excluding three patients who received lung transplantation was 74% at three yr from BOS diagnosis. Multivariate analysis showed that diagnosis of BOS within six months and FEV1 < 30% of predicted at the time of BOS diagnosis were associated with shorter survival.
An FEV1 < 30% of predicted at the time of diagnosis is significantly associated with an increased risk of death in patients with BOS after HSCT.
闭塞性细支气管炎综合征（BOS）可发生于造血干细胞移植（HSCT）后，且与显著的死亡率相关。我们研究了第一秒用力呼气容积（FEV1）作为HSCT后BOS预后标志物的作用。
在1993年12月至2013年11月期间于韩国一家三级中心接受HSCT的所有患者中，纳入了1187例患者。对患者病历进行回顾性分析，以评估这些病例中与生存相关的预后因素。
在HSCT后的中位随访期30.7个月内，82例患者（6.9%）被诊断为BOS。BOS患者的平均FEV1为预测值的34.7%，其中31例患者（37.8%）的平均FEV1<预测值的30%。排除3例接受肺移植的患者后，BOS患者自BOS诊断起3年的估计总生存率为74%。多因素分析显示，BOS诊断后6个月内确诊以及BOS诊断时FEV1<预测值的30%与较短的生存期相关。
诊断时FEV1<预测值的30%与HSCT后BOS患者死亡风险增加显著相关。
