Current Approach to Non-Infectious Pulmonary Complications of Hematopoietic Stem Cell Transplantation

Abstract

Hematopoietic stem cell transplantation is an established treatment for patients with a wide range of malignant and nonmalignant conditions. Noninfectious pulmonary complications still remain a leading cause of morbidity and mortality in these patients. Treating hematopoietic stem cell transplantation recipients with noninfectious pulmonary complications is still challenging, and the current treatment armamentarium and strategies are not adequate for patients receiving hematopoietic stem cell transplantation. Further trials are needed for a better description of the pathogenesis and the complete diagnostic criteria as well as for the development of effective therapeutic approaches for the management of noninfectious pulmonary complications of the hematopoietic stem cell transplantation. This review outlines the incidence, risk factors, pathogenesis, and clinical spectrum and discusses the current approaches to the management of noninfectious pulmonary complications of Hematopoietic stem cell transplantation.

Keywords: Bronchiolitis Obliterans syndrome Idiopathic Pneumonia syndrome.; Hematopoietic stem cell transplantation; pulmonary complications.

Figure 1. The timeline of the primary pulmonary complications following [Chi et al. (19)]. BOS: Bronchiolitis Obliterans syndrome; BOOP: bronchiolitis obliterans organizing pneumonia; CHF: congestive heart failure; DAH: diffuse alveolar hemorrhage; DPTS: Delayed Pulmonary Toxicity syndrome; GVHD: graft versus host disease IPS: Idiopathic Pneumonia syndrome; PCT: pulmonary cytolytic thrombi; PERDS: Periengraftment Respiratory Distress syndrome; PTLPD: post-transplant lymphoproliferative disorder; PVOD: pulmonary veno-occlusive disease

Figure 2. An algorithmic approach to the management of pulmonary complications after hematopoietic stem cell transplantation [Afessa et al. (7)].