Outcomes of Lung Transplantation for Bronchiolitis Obliterans after Hematopoietic Stem Cell Transplantation Compared with Those for Idiopathic Pulmonary Fibrosis
- Author:
Bong Suk PARK
1
;
Ha Eun KIM
;
Young Ho YANG
;
Dae Joon KIM
;
Chang Young LEE
;
Byung Jo PARK
;
A La WOO
;
Eun Young KIM
;
Moo Suk PARK
;
Song Yee KIM
;
Jin Gu LEE
Author Information
- Publication Type:Original Article
- From:Yonsei Medical Journal 2026;67(1):27-33
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Bronchiolitis obliterans syndrome (BOS) can develop as a manifestation of graft-versus-host disease following allogeneic hematopoietic stem cell transplantation (allo-HSCT), and may ultimately require lung transplantation (LT). However, reports on LT outcomes for BOS after allo-HSCT are limited. This study aimed to compare the outcomes of LT for BOS following allo-HSCT with those for idiopathic pulmonary fibrosis (IPF).
Materials and Methods:A total of 487 patients underwent LT between January 2010 and August 2023. Among them, the baseline characteristics and outcomes of 35 patients with BOS following allo-HSCT and 216 patients with IPF were analyzed.
Results:The BOS group was younger and had a lower body mass index (BMI) compared to the IPF group (33.7±11.9 years vs.59.7±7.3 years, p<0.001; 17.6±3.7 kg/m2 vs. 22.0±3.6 kg/m2 , p<0.001, respectively). The proportion of male patients was lower in the BOS group than in the IPF group (54.3% vs. 84.3%, p<0.001). Preoperative ventilator support was more common in the BOS group compared to the IPF group (62.9% vs. 32.4%, p=0.001). In Kaplan–Meier survival analysis, the 5-year survival rate was significantly higher in the BOS group than in the IPF group (71.0% vs. 44.9%, p=0.022). In the Cox proportional hazards model, age was the only factor significantly associated with survival [hazard ratio (95% confidence interval): 1.04 (1.02–1.07), p<0.001].
Conclusion:The survival rate of the BOS group was not inferior to that of the IPF group after adjusting for sex, age, and BMI. Therefore, LT should be actively considered as a treatment option for patients with BOS following allo-HSCT.
