Non-infectious respiratory complications after allogeneic bone marrow transplantation: single center experience in Egypt

Abstract

Hematopoietic progenitor cells are infused intravenously, known as hematopoietic stem cell transplantation. The range of pulmonary problems after transplantation of hematopoietic stem cells varies significantly from infectious to non-infectious aetiologies. To study noninfectious respiratory complications in patients subjected to allogeneic bone marrow transplants. This retrospective study was carried out on 1000 patients with hematopoietic stem-cell transplantations. These patients were presented with respiratory symptoms suggestive of pulmonary complications following bone marrow transplant. The number of patients in this period was 1000 patients, and 247 of them had non-infectious pulmonary complications. Number and percent of bronchiolitis obliterans, diffuse alveolar hemorrhage, graft-versus-host disease (GVHD), pulmonary edema, Bronchiolitis obliterans with GVHD, Chemotherapy pneumonitis, Idiopathic pneumonia syndrome and Thoracic air leak syndrome to all number of cases were twenty-five (2.5%), sixteen (1.6%), eighty-one (8.1) sixty-four (25.9%), nineteen (1.9%), twenty-one (2.1%), thirteen (1.3%) and eight (0.8%) respectively, but number and percent of bronchiolitis obliterans, diffuse alveolar hemorrhage, GVHD, pulmonary edema, bronchiolitis obliterans with GVHD, chemotherapy-associated pneumonitis, Idiopathic pneumonia syndrome, and thoracic air leak syndrome to all complicated cases only were twenty-five (10.1%), sixteen (6.5%), eighty-one (32.8%), sixty-four (25.9 %), nineteen (7.7%), twenty-one (8.5 %), thirteen (5.3 %) and eight (3.2%) respectively. Noninfectious respiratory complications included GVHD, pulmonary edema, bronchiolitis obliterans and diffuse alveolar hemorrhage bronchiolitis obliterans with GVHD, chemotherapy-associated pneumonitis, Idiopathic pneumonia syndrome, and thoracic air leak syndrome. Some of them occurred early, and some occurred late. The incidence of non-infectious respiratory complications is affected by increased patient age and female gender.