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Bronchiolitis obliterans after autologous bone marrow transplantation
H L Paz1, P Crilley, A Patchefsky
1Department of Medicine, Hahnemann University, Philadelphia, Pa. 19102-1192.
Chest
|March 1, 1992
Summary
Autologous bone marrow transplant recipients can develop severe lung disease, specifically bronchiolitis obliterans. This condition, previously associated with allogeneic transplants, poses a significant risk for respiratory failure in these patients.
Area of Science:
- Pulmonology
- Hematology
- Oncology
Background:
- Autologous bone marrow transplantation (AuBMT) is a common procedure for treating lymphoma.
- Obliterative bronchiolitis (BrOb) is a severe lung disease typically associated with allogeneic bone marrow transplantation (AlloBMT).
Observation:
- Two patients who underwent AuBMT for lymphoma developed rapidly progressive respiratory insufficiency.
- Clinical symptoms included persistent cough, exertional dyspnea, inspiratory rales, and expiratory wheezing.
- Pulmonary function tests indicated severe, rapidly progressive respiratory disease.
Findings:
- Both patients experienced a decline in respiratory function despite aggressive immunosuppressive therapy.
- Histologic examination confirmed bronchiolitis obliterans (BrOb) in both cases.
- Both patients ultimately died from respiratory insufficiency.
Implications:
- Life-threatening obliterative bronchiolitis (BrOb) can occur after autologous bone marrow transplantation (AuBMT), not exclusively allogeneic.
- Awareness of this risk in AuBMT patients is crucial for early diagnosis and intervention.
- Early recognition and treatment may improve outcomes for patients at risk of BrOb post-transplant.