Thoracic Air-leak Syndromes In Hematopoietic Stem Cell Transplant Recipients with Graft-versus-Host Disease: A Possible Sign for Poor Response to Treatment and Poor Prognosis.
10.3346/jkms.2010.25.5.658
- Author:
Mi Hyoung MOON
1
;
Young Jo SA
;
Kyu Do CHO
;
Keon Hyon JO
;
Sun Hee LEE
;
Sung Bo SIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Pleural Diseases;
Bronchiolitis Obliterans;
Hematopoietic Stem Cell Transplantation;
Graft vs Host Disease
- MeSH:
Adolescent;
Adult;
Comorbidity;
Female;
Graft vs Host Disease/*mortality/*surgery;
Hematopoietic Stem Cell Transplantation/*mortality;
Hemothorax/*mortality;
Humans;
Incidence;
Korea;
Male;
Middle Aged;
Pneumothorax/*mortality;
Prognosis;
Risk Assessment;
Risk Factors;
Survival Analysis;
Survival Rate;
Syndrome;
Treatment Outcome;
Young Adult
- From:Journal of Korean Medical Science
2010;25(5):658-662
- CountryRepublic of Korea
- Language:English
-
Abstract:
Bronchiolitis obliterans (BO) or bronchiolitis obliterans organizing pneumonia (BOOP) is one of manifestations of graft-versus-host disease (GVHD), a complication of hematopoietic stem cell transplantation (HSCT). Recently there are reports about thoracic air-leakage syndrome (TALS), but real incidence, clinical course, and implications of TALS remain unclear. Retrospective review of 18 TALS patients among 2,177 patients who received allogeneic HSCT between January 2000 to July 2007 was done. Clinical manifestations, treatments, and outcomes of TALS were reviewed. The incidence of TALS was 0.83% (18/2,177). The onset of TALS was mean 425.9+/-417.8 days (60-1,825 days) after HSCT, and the duration was mean 16.3+/-21 days (2-90 days). The most common types of TALS were spontaneous pneumothroax (n=14), followed by subcutaneous emphysema (n=6), pneumomediastinum (n=5), interstitial emphysema (n=2), and pneumopericardium (n=1). TALS persisted in six patients, who died during the same hospitalization. The 12 patients recovered from TALS, but only 2 survived, while others died due to aggravation of GVHD. TALS may complicate BO/BOOP and be an initial manifestation of BO/BOOP. TALS is hard to be resolved, and even after the recovery, patients die because of aggravation of GVHD. We suggest specifically in HSCT patients, when once developed, TALS seems hard to be cured, and as a result, be related to high fatality.
