Early and Rapid Development of Bronchiolitis Obliterans Syndrome after Allogeneic Hematopoietic Cell Transplantation

Authors

Jacqueline S Dickey
Burton F Dickey
Amin M Alousi
Richard E Champlin
Ajay Sheshadri

Publication Date

1-1-2024

Journal

Respiratory Medicine Case Reports

Abstract

Bronchiolitis obliterans (BO) is a form of graft-versus-host disease (GVHD) in the lung and manifests as moderate to severe airflow obstruction after hematopoietic stem cell transplantation (HCT). New-onset airflow obstruction on spirometry is considered diagnostic of bronchiolitis obliterans syndrome (BOS). BOS affects about 5% of all HCT recipients. In general, BO is thought of as a late complication of HCT, usually occurring after day 100 post-transplantation. However, the onset of airflow obstruction can be rapid and is most often irreversible even with treatment. We describe a patient who rapidly developed severe airflow obstruction less than one month after transplantation following the development of upper airway symptoms. Despite aggressive immunosuppression, the patient had no improvement in airflow obstruction. We hypothesize that early screening and treatment may help prevent BOS after HCT.

Keywords

Bronchiolitis obliterans syndrome, Hematopoietic cell transplantation, Handheld spirometry, Screening

Comments

PMID: 38745870