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
Diagnosi...
...ommendation 1We recommend pre-HSCT spirometry, st...
...2aWe suggest active surveillance rather...
...ecommendation 2bWe suggest spirometry and w...
...ommendation 2cFor long-term follow-up in asy...
...ndation 3aAt centers with adequate techn...
...commendation 3bAt centers with adequate...
...on 4aWe suggest performing a chest computed tomog...
...on 4bWe suggest performing a chest CT...
...We suggest bronchoscopy with bronchoalveolar lavag...
...ommendation 6We suggest surgical lung biopsy...
...Recommended Frequency of PFT Testing in...
...able 2. Recommendations for Chest CT in...
...Role of Bronchoscopy With BAL in Evaluation of...
...Proposed Criteria for Diagnosis of Pediatric Post...
...Surveillance and Diagnosis of...