Comparison of Pulmonary Complications after Nonmyeloablative and Conventional Allogeneic Hematopoietic Cell Transplant

Khalil J. Diab, Zhangsheng Yu, Karen L. Wood, James A. Shmalo, Francis D. Sheski, Mark O. Farber, David S. Wilkes, Robert P. Nelson

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Nonmyeloablative conditioning before allogeneic hematopoietic cell transplant (HCT) is an alternative to conventional conditioning in older patients and those with comorbidities. It is not known whether the decreased tissue injury associated with nonmyeloablative conditioning lowers the risk of pulmonary complications. The medical records of patients who underwent transplantation were reviewed and all pulmonary complications documented. Sixty-two consecutive patients with hematologic malignancies who underwent minimally intensive HCT (subjects) were compared to 48 consecutive patients who received conventional myeloablative allogeneic peripheral blood HCT (controls) over the same period at Indiana University Hospital. Pulmonary complications were categorized according to the type of complication and the time of onset after transplantation. Median follow-up times were similar between groups (P = .70). The study population (minimal intensity recipients) was older (P < .01), and the incidence of chronic graft-versus-host disease (cGVHD) was higher in subjects than controls (P = .02). Sixty-nine percent of subjects and 73% of controls developed pulmonary complications (P = .70). There was a trend in the minimally conditioned patients towards a lower incidence of pulmonary complications in older patients in the early posttransplantation period and a higher incidence of infectious pneumonias and bronchiolitis obliterans syndrome at later time points. The frequency of pulmonary complications seems to be similar after minimally intensive or myeloablative conditioning and allotransplantation. There was no difference in overall mortality or pulmonary-related mortality between the 2 groups.

Original languageEnglish (US)
Pages (from-to)1827-1834
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume18
Issue number12
DOIs
StatePublished - Dec 1 2012

Keywords

  • Bronchiolitis obliterans syndrome
  • Hematopoietic cell transplant
  • Nonmyeloablative conditioning
  • Pulmonary complications

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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