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. 2010 Jun;16(6):782-91.
doi: 10.1016/j.bbmt.2009.12.534. Epub 2010 Jan 6.

Strong association between respiratory viral infection early after hematopoietic stem cell transplantation and the development of life-threatening acute and chronic alloimmune lung syndromes

A Birgitta Versluys  1 , John W A Rossen, Bart van Ewijk, Rob Schuurman, Marc B Bierings, Jaap J Boelens
Affiliations

Strong association between respiratory viral infection early after hematopoietic stem cell transplantation and the development of life-threatening acute and chronic alloimmune lung syndromes

A Birgitta Versluys et al. Biol Blood Marrow Transplant. 2010 Jun.

Abstract

Alloimmune lung syndromes (allo-LS), including idiopathic pneumonia syndrome, bronchiolitis obliterans syndrome, and bronchiolitis obliterans organizing pneumonia, are severe complications after hematopoietic stem cell transplantation (HSCT). In our cohort of 110 pediatric patients, 30 had allo-LS (27.3%), 18 with idiopathic pneumonia syndrome and 12 with bronchiolitis obliterans syndrome. Multivariate analysis showed that respiratory viral infection early after HSCT is an important predictor for the development of allo-LS (P <.0001). This was true for all viruses tested. In multivariate analysis, allo-LS was the only predictor for higher mortality (P = .04). Paradoxically, prolonged administration of immunosuppressive agents because of acute graft-versus-host disease had a protective effect on the development of allo-LS (P = .004). We hypothesize that early infection of the respiratory tract with a common cold virus makes the lungs a target for alloimmunity.

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Figures

Figure 1
Figure 1
RV= Respiratory Virus, allo-LS = alloimmune lungsyndrome, aGVHD = acute graft versus host disease, IPS = Idiopathic Pulmonary Syndrome, BO = Bronchiolitis Obliterans (Syndrome).
See this image and copyright information in PMC

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