Bronchiolitis Obliterans Syndrome Following Pediatric Hematopoietic Stem Cell Transplant
Publication Date: June 18, 2024
Key Points
Key Points
- Pulmonary complications occur frequently following pediatric hematopoietic stem cell transplant (HSCT).
- Pulmonary complications are a significant contributor to morbidity and mortality, affecting 25% to 60% children following HSCT and causing 25% to 65% of non-relapse mortality.
- The most common non-infectious pulmonary complication following HSCT is bronchiolitis obliterans syndrome (BOS), a manifestation of lung chronic graft vs. host disease (cGvHD) affecting 4.5–8.3% of children post-HSCT.
- Given that initial phases of BOS are often asymptomatic, surveillance with pulmonary function testing (PFT) is recommended.
Diagnosis
...agnosi...
...1We recommend pre-HSCT spirometry, static l...
...ation 2aWe suggest active surveillance rather tha...
Recommendation 2bWe suggest spirometry and where...
...n 2cFor long-term follow-up in asymptomatic...
...ation 3aAt centers with adequate tech...
...mendation 3bAt centers with adequate tec...
...4aWe suggest performing a chest computed tomog...
...4bWe suggest performing a chest CT scan...
...ation 5We suggest bronchoscopy with...
...on 6We suggest surgical lung biopsy i...
...Recommended Frequency of PFT Testing in...
...2. Recommendations for Chest CT in Children...
...Role of Bronchoscopy With BAL in E...
...New Proposed Criteria for Diagnosis...
...rveillance and Diagnosis of BOS...