A casecontrol study of bronchiolitis obliterans syndrome following allogeneic hematopoietic stem cell transplantation

作者：Nakasone Hideki^*; Kanda Junya; Yano Shingo; Atsuta Yoshiko; Ago Hiroatsu; Fukuda Takahiro; Kakihana Kazuhiko; Adachi Tatsuya; Yujiri Toshiaki; Taniguchi Shuichi; Taguchi Jun; Morishima Yasuo; Nagamura Tokiko; Sakamaki Hisashi; Mori Takehiko; Murata Makoto

来源：Transplant International, 2013, 26(6): 631-639.

DOI：10.1111/tri.12093

• ABO-mismatch
• allogeneic hematopoietic stem cell transplantation
• bronchiolitis obliterans syndrome
• cord blood
• graft-versus-host disease

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 casecontrol 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%26lt;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.

• 出版日期2013-6
• 单位河北医科大学