Lung Transplantation for Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation
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초록
Bronchiolitis obliterans (BO) is a late onset complication of allogeneic hematopoietic stem cell transplantation (HSCT), and treatment outcome is dismal if it does not respond to immunosuppressive therapy. A 21-year-old male diagnosed with acute myeloid leukemia received an allogeneic HSCT from human leukocyte antigen-identical sibling donor. Twenty one months after transplantation, he developed progressive dyspnea and was diagnosed BO. Despite standard immunosuppressive therapy, the patient rapidly progressed to respiratory failure and Novalung® interventional lung-assist membrane ventilator was applied in the intensive care unit. Three months after the diagnosis of BO, the patient underwent bilateral lung transplantation (LT) and was eventually able to wean from the ventilator and the Novalung ®. Since the LT, the patient has been under a strict rehabilitation program in order to overcome a severe lower extremity weakness and muscle atrophy. Histologic findings of the explanted lungs confirmed the diagnosis of BO. Nine months after the LT, the patient showed no signs of rejection or infectious complications, but still required rehabilitation treatment. This is the first LT performed in a patient with BO after allogeneic HSCT in Korea. LT can be an effective therapy in terms of survival for patients with respiratory failure secondary to development of BO following HSCT.
Abstract
Bronchiolitis obliterans (BO) is a late onset complication of allogeneic hematopoietic stem cell transplantation (HSCT), and treatment outcome is dismal if it does not respond to immunosuppressive therapy. A 21-year-old male diagnosed with acute myeloid leukemia received an allogeneic HSCT from human leukocyte antigen-identical sibling donor. Twenty one months after transplantation, he developed progressive dyspnea and was diagnosed BO. Despite standard immunosuppressive therapy, the patient rapidly progressed to respiratory failure and Novalung® interventional lung-assist membrane ventilator was applied in the intensive care unit. Three months after the diagnosis of BO, the patient underwent bilateral lung transplantation (LT) and was eventually able to wean from the ventilator and the Novalung ®. Since the LT, the patient has been under a strict rehabilitation program in order to overcome a severe lower extremity weakness and muscle atrophy. Histologic findings of the explanted lungs confirmed the diagnosis of BO. Nine months after the LT, the patient showed no signs of rejection or infectious complications, but still required rehabilitation treatment. This is the first LT performed in a patient with BO after allogeneic HSCT in Korea. LT can be an effective therapy in terms of survival for patients with respiratory failure secondary to development of BO following HSCT.
참고문헌 (17)
- Armitage JO, "Bone marrow transplantation", N Engl J Med, 330, pp.827~838 (1994)
- Filipovich AH, "National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report", Biol Blood Marrow Transplant, 11, pp.945~956 (2005)
- Redel-Montero J, "Lung transplantation for bronchiolitis obliterans after allogenic bone marrow transplantation", Transplant Proc, 42, pp.3023~3025 (2010)
- Jae Wook Lee, "Prognostic Implications of the NIH Consensus Criteria in Children with Chronic Graft-versus-Host Disease", Yonsei Medical Journal, 52(5), pp.779~786 (2011), 연세대학교의과대학
- Calhoon JH, "Lung transplantation in a patient with a prior bone marrow transplant", Chest, 102, pp.948~ (1992)
- Santo Tomas LH, "Risk factors for bronchiolitis obliterans in allogeneic hematopoietic stem-cell transplantation for leukemia", Chest, 128, pp.153~161 (2005)
- Chien JW, "Airflow obstruction after myeloablative allogeneic hematopoietic stem cell transplantation", Am J Respir Crit Care Med, 168, pp.208~214 (2003)
- Dudek AZ, "Bronchiolitis obliterans in chronic graft-versus-host disease: analysis of risk factors and treatment outcomes", Biol Blood Marrow Transplant, 9, pp.657~666 (2003)
- Majhail NS, "Improvement of pulmonary function with imatinib mesylate in bronchiolitis obliterans following allogeneic hematopoietic cell transplantation", Biol Blood Marrow Transplant, 12, pp.789~791 (2006)
- Fullmer JJ, "Successful treatment of bronchiolitis obliterans in a bone marrow transplant patient with tumor necrosis factor-alpha blockade", Pediatrics, 116, pp.767~770 (2005)
- Smith EP, "Extracorporeal photochemotherapy for treatment of drug-resistant graft-vs.-host disease", Biol Blood Marrow Transplant, 4, pp.27~37 (1998)
- Alcindor T, "Immunomodulatory effects of extracorporeal photochemotherapy in patients with extensive chronic graft-versus-host disease", Blood, 98, pp.1622~1625 (2001)
- Rabitsch W, "Successful lung transplantation for bronchiolitis obliterans after allogeneic marrow transplantation", Transplantation, 71, pp.1341~1343 (2001)
- Gascoigne A, "Lung transplants in patients with prior bone marrow transplants", Chest, 105, pp.327~ (1994)
- Svendsen UG, "Transplantation of a lobe of lung from mother to child following previous transplantation with maternal bone marrow", Eur Respir J, 8, pp.334~337 (1995)
- Oshima K, "Living-donor single lobe lung transplantation for bronchiolitis obliterans from mother to child following previous allogeneic hematopoietic stem cell transplantation from the same donor", Int J Hematol, 90, pp.540~542 (2009)
- Svendsen UG, "Transplantation of a lobe of lung from mother to child following previous transplantation with maternal bone marrow", J Heart Lung Transplant, 18, pp.388~390 (1999)