Bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: phenotypes and prognosis.

Bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: phenotypes and prognosis.
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同种异体造血SCT后,支气管炎闭塞性综合征:表型和预后。

DOI:
10.1038/bmt.2012.241
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发表时间:
2013-06
影响因子:
4.8
通讯作者:
Tazi A
Tazi A
中科院分区:
医学3区
文献类型:
--
作者:
Bergeron A;Godet C;Chevret S;Lorillon G;Peffault de Latour R;de Revel T;Robin M;Ribaud P;Socié G;Tazi A

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异基因造血SCT(HSCT)后闭塞性细支气管炎综合征(BOS)被认为是肺功能检测中新发的阻塞性肺缺陷(OLD),并且与肺部慢性GVHD相关。对于 BOS 患者的不同表型及其结果知之甚少。我们回顾了 1999 年至 2010 年间因非传染性支气管疾病转诊至我们肺科的所有同种异体 HSCT 受者的数据。我们确定了 103 名患者(BOS (n=77)、哮喘 (n=11) 和慢性支气管炎 (n=15))。在 BOS 患者中,我们确定了两种功能表型:典型的 OLD,即 1 秒用力呼气量 (FEV1)/用力肺活量 (FVC) 比值 <0.7 (n=53),以及非典型 OLD,伴随着正常总肺活量预测的 FEV1 <80% 和 FVC <80% 的降低 (n=24)。典型的 OLD 的特点是 FEV1 更严重,计算机断层扫描显示小叶中心结节更少。无论表型如何,FEV1 在随访期间均未受到显着影响。除了急性和广泛的慢性 GVHD 之外,只有移植后不久发生 BOS 以及用类固醇有意治疗 BOS 与生存率较差有关。应探索确定患者亚组以改善这种情况的管理。
Bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic SCT (HSCT) is recognized as a new-onset obstructive lung defect (OLD) in pulmonary function testing and is related to pulmonary chronic GVHD. Little is known about the different phenotypes of patients with BOS and their outcomes. We reviewed the data of all allogeneic HSCT recipients referred to our pulmonary department for a non-infectious bronchial disease between 1999 and 2010. We identified 103 patients (BOS (n=77), asthma (n=11) and chronic bronchitis (n=15)). In patients with BOS, we identified two functional phenotypes: a typical OLD, that is, forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7 (n=53), and an atypical OLD with a concomitant decrease in the FEV1 <80% and FVC <80% predicted with a normal total lung capacity (n=24). The typical OLD was characterized by more severe FEV1 and fewer centrilobular nodules on the computed tomography scan. The FEV1 was not significantly affected during the follow-up, regardless of the phenotype. In addition to acute and extensive chronic GVHD, only the occurrence of BOS soon after transplantation and the intentional treatment of BOS with steroids were associated with a poor survival. The determination of patient subgroups should be explored to improve the management of this condition.
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发表时间: 2011-10-01
影响因子: 4.8
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