PMID- 21909046
OWN - NLM
STAT- MEDLINE
DCOM- 20120511
LR  - 20120118
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 31
IP  - 2
DP  - 2012 Feb
TI  - Lethal pulmonary complications after pediatric allogeneic hematopoietic stem cell 
      transplantation.
PG  - 115-9
LID - 10.1097/INF.0b013e31823345e5 [doi]
AB  - INTRODUCTION: Hematopoietic stem cell transplantation (HSCT) in children is 
      accompanied by a transplant-related mortality of 10% to 30%, which is the result 
      of lethal pulmonary complications (LPCs) in many cases. METHODS: We 
      retrospectively assessed prevalence and risk factors of LPC following 234 
      allogeneic HSCTs in 228 patients for malignant or nonmalignant diseases at a 
      single institution. RESULTS: Pulmonary complications (PCs) were observed 
      following 81 of 234 transplants (35%). LPCs were observed in 4% of HSCT within 
      100 days and in 14% within 5 years after HSCT. Late PCs after day 100 were lethal 
      in 56% (22/39) of the patients with PCs, who are 11% (22/202) of all evaluable 
      patients still alive after day +100. Causes of LPC after day 100 were viral (10 
      cases), bacterial (1 case), fungal (5 cases) pulmonary infection, or 
      noninfectious (6 cases) PCs. Abnormal pretransplant pulmonary function test was 
      not associated with an increased risk of LPC. Children older than 10 years and 
      those undergoing a second HSCT had an increased incidence of overall LPC. T-cell 
      depletion and mismatched donor HSCT (P = 0.001), but not age, were associated 
      with an increased risk of lethal viral pneumonia. CONCLUSIONS: Transplant-related 
      mortality up to 5 years after HSCT in children was associated with LPC in 14%. 
      There were more late (>100 days) than early LPCs, predominantly due to infectious 
      etiologies and affecting children >10 years of age.
FAU - Fazekas, Tamas
AU  - Fazekas T
AD  - Department of Hematopoietic Stem Cell Transplantation, St. Anna Children's 
      Hospital, Vienna, Austria.
FAU - Attarbaschi, Andishe
AU  - Attarbaschi A
FAU - Lawitschka, Anita
AU  - Lawitschka A
FAU - Seidel, Markus
AU  - Seidel M
FAU - Potschger, Ulrike
AU  - Potschger U
FAU - Peters, Christina
AU  - Peters C
FAU - Mann, Georg
AU  - Mann G
FAU - Gadner, Helmut
AU  - Gadner H
FAU - Matthes-Martin, Susanne
AU  - Matthes-Martin S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Hematopoietic Stem Cell Transplantation/*adverse effects
MH  - Humans
MH  - Infant
MH  - Lung Diseases/*chemically induced/epidemiology/*mortality
MH  - Male
MH  - Pediatrics
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Young Adult
EDAT- 2011/09/13 06:00
MHDA- 2012/05/12 06:00
CRDT- 2011/09/13 06:00
PHST- 2011/09/13 06:00 [entrez]
PHST- 2011/09/13 06:00 [pubmed]
PHST- 2012/05/12 06:00 [medline]
AID - 10.1097/INF.0b013e31823345e5 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2012 Feb;31(2):115-9. doi: 10.1097/INF.0b013e31823345e5.