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T-cell depletion prevents from bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia after allogeneic hematopoietic stem cell transplantation with related donors

From the Department of bone marrow transplantation, University Hospital of Essen, Hufelandstr. 55, 45122 Essen, Germany.

Correspondence:Markus Ditschkowski, MD, University Hospital of Essen, Department of bone marrow transplantation, Hufelandstrasse 55, 45122 Essen, Germany. E-mail: markus.ditschkowski{at}uni-essen.de

Bronchiolitis obliterans (BO) and bronchiolitis obliterans organizing pneumonia (BOOP) are late-onset non-infectious pulmonary complications (LONIPCs) following allogeneic hematopoietic stem cell transplantation (HSCT). In the present study 10 of 197 conventionally prepared stem cell recipients developed BOOP after 365 days and 6 patients developed BO 333 days post-transplant. No BOOP or BO was diagnosed following T-cell depletion (p<0.05). Chronic GVHD was ascertained in all BOOP patients and appeared significantly (p<0,001) more frequent in the conventional transplant group. The data confirm a strong association between T-cell activity, chronic GVHD, BO and BOOP and point out the impact of T lymphocytes in the pathomechanism of BOOP.

Key words: bronchiolitis obliterans, pneumonia, stem cell transplantation.