Sinonasal disorders in hematopoietic stem cell transplantation

Area of Science:

• Immunology
• Transplantation Medicine
• Otolaryngology

Background:

• Hematopoietic stem cell transplantation (HSCT) is a critical treatment for hematological diseases.
• Immunosuppression following HSCT significantly elevates the risk of respiratory infections.
• Rhinosinusitis is a common complication post-HSCT, impacting patient recovery and quality of life.

Purpose of the Study:

• To determine the incidence of rhinosinusitis in patients undergoing HSCT.
• To investigate the association between rhinosinusitis and chronic graft-versus-host disease (GVHD).
• To explore the relationship between rhinosinusitis and transplant type, treatments, and patient survival.

Main Methods:

• Retrospective study conducted at a tertiary university hospital.
• Analysis of 95 patients with hematological diseases who underwent HSCT between 1996 and 2011.
• Data collection on rhinosinusitis occurrence, GVHD, transplant type, treatments, and survival outcomes.

Main Results:

• Rhinosinusitis was diagnosed in 36% of HSCT patients, with no significant difference between autologous and allogeneic transplants.
• Chronic GVHD developed in 30% of patients, correlating with a higher frequency and recurrence of rhinosinusitis.
• Patients with GVHD required more frequent endoscopic sinusectomy and experienced decreased overall survival.

Conclusions:

• Rhinosinusitis is a frequent complication after HSCT, particularly in patients with GVHD.
• The type of HSCT (autologous vs. allogeneic) does not influence rhinosinusitis occurrence.
• GVHD acts as an aggravating factor for rhinosinusitis, necessitating more aggressive management strategies and closer monitoring to improve patient outcomes.