Pulmonary complications following hematopoietic stem cell transplantation in children

Özet

In this retrospective study, we evaluated 195 patients for the development ofpulmonary complications after HSCT within a 10 years of period. Pulmonarycomplications developed in 71 (36.4%) patients. Of the 71 patients who hadpulmonary complications, 60 had one pulmonary complication, 11 had twopulmonary complications. Pulmonary complications were diagnosed as early in42 (51.2%) and late in 40 (48.8%) episodes. Pulmonary complications wereinfectious in 28 (34.1%), noninfectious in 20 (24.4%) and both infectiousand nonfectious in 34 (41.5%) episodes. Pulmonary complications developedsignificantly more frequently in patients with malignancy, congenital immunedeficiency and with at least one pulmonary disease before HSCT. The numberof patients who had myeloablative conditioning regimen was significantly higherin the group of patients without pulmonary complications than the group withpulmonary complications. However, in multivariate analysis, none of thesevariables were shown to be effective in predicting pulmonary complicationsafter HSCT (p>0.05). During follow up, 54 (65.8%) episodes recovered, 20(24.3%) episodes resulted with death due to pulmonary complications, 6(7.3%) episodes had chronic pulmonary disease (bronchiolitis obliterans (BO)and bronchiolitis obliterans organizing pneumonia (BOOP)); 2 patients (eachpatient with one episode) were lost to follow up. In conclusion; identifyingchildren who are at risk for severe pulmonary complications and closelongitudinal follow-up after HSCT by pediatric pulmonologists is mandatoryto increase survival and life quality of these patients.