Pulmonary Complications in Pediatric and Adolescent Patients Following Allogeneic Hematopoietic Cell Transplantation

Larisa Broglie, Caitrin Fretham, Amal Al-Seraihy, Biju George, Joanne Kurtzberg, Alison Loren, Margaret L MacMillan, Caridad Martinez, Stella M. Davies, Marcelo C. Pasquini

Research output: Contribution to journalArticle

Abstract

Pulmonary complications after hematopoietic cell transplantation (HCT) can lead to significant morbidity and mortality. Limited evaluation of the true incidence of these complications in children and subsequent outcomes of these complications have not been evaluated recently. In April 2018, the National Heart, Lung, and Blood Institute; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; and the National Cancer Institute cosponsored a meeting of experts to describe the status of pulmonary complications in children after HCT, identify critical gaps in knowledge, and explore avenues for research to advance care and optimize outcomes. The Center for International Blood and Marrow Transplant Research was used to evaluate the cumulative incidence of pulmonary complications in children and their respective survival. Of the 5022 children included in this analysis who received allogeneic HCT from 2010 to 2016, 606 developed pulmonary complications within the first year after HCT. Pneumonitis occurred in 388 patients, 125 patients developed pulmonary hemorrhage, and 200 patients had lung graft-versus-host disease (GVHD). For those developing pulmonary complications within 1 year, overall survival 100 days after diagnosis of pulmonary complications was 49% (95% confidence interval [CI], 43% to 54%) for patients with pneumonitis, 23% (95% CI, 16% to 31%) in patients with pulmonary hemorrhage, and 87% (95% CI, 81% to 91%) in patients with pulmonary GVHD. This study demonstrates the approximate incidence of these complications, as well as their significant effects on survival, and can serve as a baseline for future research.

Original languageEnglish (US)
Pages (from-to)2024-2030
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2019

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Cell Transplantation
Pediatrics
Lung
Graft vs Host Disease
Confidence Intervals
Survival
Incidence
Pneumonia
National Institute of Child Health and Human Development (U.S.)
Hemorrhage
National Heart, Lung, and Blood Institute (U.S.)
National Cancer Institute (U.S.)
Research
Bone Marrow
Morbidity
Transplants
Mortality

Keywords

  • Lung GVHD
  • Pediatrics
  • Pneumonitis
  • Pulmonary hemorrhage

Cite this

Pulmonary Complications in Pediatric and Adolescent Patients Following Allogeneic Hematopoietic Cell Transplantation. / Broglie, Larisa; Fretham, Caitrin; Al-Seraihy, Amal; George, Biju; Kurtzberg, Joanne; Loren, Alison; MacMillan, Margaret L; Martinez, Caridad; Davies, Stella M.; Pasquini, Marcelo C.

In: Biology of Blood and Marrow Transplantation, Vol. 25, No. 10, 01.10.2019, p. 2024-2030.

Research output: Contribution to journalArticle

Broglie, L, Fretham, C, Al-Seraihy, A, George, B, Kurtzberg, J, Loren, A, MacMillan, ML, Martinez, C, Davies, SM & Pasquini, MC 2019, 'Pulmonary Complications in Pediatric and Adolescent Patients Following Allogeneic Hematopoietic Cell Transplantation', Biology of Blood and Marrow Transplantation, vol. 25, no. 10, pp. 2024-2030. https://doi.org/10.1016/j.bbmt.2019.06.004
Broglie, Larisa ; Fretham, Caitrin ; Al-Seraihy, Amal ; George, Biju ; Kurtzberg, Joanne ; Loren, Alison ; MacMillan, Margaret L ; Martinez, Caridad ; Davies, Stella M. ; Pasquini, Marcelo C. / Pulmonary Complications in Pediatric and Adolescent Patients Following Allogeneic Hematopoietic Cell Transplantation. In: Biology of Blood and Marrow Transplantation. 2019 ; Vol. 25, No. 10. pp. 2024-2030.
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