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Les complications pulmonaires non infectieuses de l’allogreffe de cellules souches hématopoïétiques

Non-infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation

  • Enseignement Supérieur en Réanimation
  • Médecin
  • Published:
Réanimation

Résumé

Les complications pulmonaires non infectieuses (CPNI) émaillent fréquemment le suivi des patients ayant reçu une allogreffe de cellules souches hématopoïétiques (ACSH) et sont pourvoyeuses d’une mortalité et morbidité importantes. Elles peuvent survenir à différents moments au décours de l’ACSH et concernent les différents territoires anatomiques pulmonaires. Différentes entités histopathologiques ont été décrites, parmi lesquelles la bronchiolite oblitérante constitue la pathologie la plus souvent rencontrée. Bien que leur pathogénie soit encore mal comprise, les CPNI sont le plus souvent associées à une réaction du greffon contre l’hôte (GVH). L’intensification du traitement immunosuppresseur, classiquement indiquée pour le traitement des GVH extrathoraciques peut permettre la résolution de certaines de ces CPNI, mais ce traitement est peu efficace pour d’autres, comme la bronchiolite oblitérante.

Abstract

Non-infectious pulmonary complications (NIPC) frequently occur during the follow-up of patients who underwent allogeneic hematopoietic stem cell transplantation (AHSCT). They are associated with significant mortality and morbidity. They may occur at different moments following ACSH and involve any anatomic lung area. Different histopathological entities have been described, including bronchiolitis obliterans which is the most often diagnosed disease. Despite a poorly understood pathogenesis, NIPC are usually associated with graft versus host (GVH) disease. Intensification of the immunosuppressive therapy, traditionally indicated for the treatment of extra-thoracic GVH disease may allow resolution of some NIPC; however, this treatment is ineffective in several others, like bronchiolitis obliterans.

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Références

  1. Majhail NS, Parks K, Defor TE, et al (2006) Alveolar hemorrhage following allogeneic hematopoietic cell transplantation using reduced-intensity conditioning. Bone Marrow Transplant 38:765–768

    Article  PubMed  CAS  Google Scholar 

  2. Afessa B, Tefferi A, Litzow MR, et al (2002) Diffuse alveolar hemorrhage in hematopoietic stem cell transplant recipients. Am J Respir Crit Care Med 166:641–645

    Article  PubMed  Google Scholar 

  3. Gupta S, Jain A, Warneke CL, et al (2007) Outcome of alveolar hemorrhage in hematopoietic stem cell transplant recipients. Bone Marrow Transplant 40:71–78

    Article  PubMed  CAS  Google Scholar 

  4. Raptis A, Mavroudis D, Suffredini A, et al (1999) High-dose corticosteroid therapy for diffuse alveolar hemorrhage in allogeneic bone marrow stem cell transplant recipients. Bone Marrow Transplant 24:879–883

    Article  PubMed  CAS  Google Scholar 

  5. Wanko SO, Broadwater G, Folz RJ, et al (2006) Diffuse alveolar hemorrhage: retrospective review of clinical outcome in allogeneic transplant recipients treated with aminocaproic acid. Biol Blood Marrow Transplant 12:949–953

    Article  PubMed  CAS  Google Scholar 

  6. Shenoy A, Savani BN, Barrett AJ (2007) Recombinant factor VIIa to treat diffuse alveolar hemorrhage following allogeneic stem cell transplantation. Biol Blood Marrow Transplant 13:622–623

    Article  PubMed  Google Scholar 

  7. Afessa B, Tefferi A, Litzow MR, et al (2002) Outcome of diffuse alveolar hemorrhage in hematopoietic stem cell transplant recipients. Am J Respir Crit Care Med 166:1364–1368

    Article  PubMed  Google Scholar 

  8. Ravenel JG, Scalzetti EM, Zamkoff KW (2000) Chest radiographic features of engraftment syndrome. J Thorac Imaging 15:56–60

    Article  PubMed  CAS  Google Scholar 

  9. Spitzer TR (2001) Engraftment syndrome following hematopoietic stem cell transplantation. Bone Marrow Transplant 27:893–898

    Article  PubMed  CAS  Google Scholar 

  10. Clark JG, Hansen JA, Hertz MI, et al (1993) NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am Rev Respir Dis 147:1601–1606

    Article  PubMed  CAS  Google Scholar 

  11. Panoskaltsis-Mortari A, Griese M, Madtes DK, et al (2011) An Official American Thoracic Society Research Statement: noninfectious lung injury after hematopoietic stem cell transplantation: idiopathic pneumonia syndrome. Am J Respir Crit Care Med 183:1262–1279

    Article  PubMed  Google Scholar 

  12. Cooke KR, Kobzik L, Martin TR, et al (1996) An experimental model of idiopathic pneumonia syndrome after bone marrow transplantation: I. The roles of minor H antigens and endotoxin. Blood 88:3230–3239

    PubMed  CAS  Google Scholar 

  13. Wingard JR, Mellits ED, Sostrin MB, et al (1988) Interstitial pneumonitis after allogeneic bone marrow transplantation. Nineyear experience at a single institution. Medicine (Baltimore) 67:175–186

    CAS  Google Scholar 

  14. Shankar G, Cohen DA (2001) Idiopathic pneumonia syndrome after bone marrow transplantation: the role of pre-transplant radiation conditioning and local cytokine dysregulation in promoting lung inflammation and fibrosis. Int J Exp Pathol 82:101–113

    Article  PubMed  CAS  Google Scholar 

  15. Fukuda T, Hackman RC, Guthrie KA, et al (2003) Risks and outcomes of idiopathic pneumonia syndrome after nonmyeloablative and conventional conditioning regimens for allogeneic hematopoietic stem cell transplantation. Blood 102:2777–2785

    Article  PubMed  Google Scholar 

  16. Piguet PF, Grau GE, Collart MA, et al (1989) Pneumopathies of the graft-versus-host reaction. Alveolitis associated with an increased level of tumor necrosis factor mRNA and chronic interstitial pneumonitis. Lab Invest 61:37–45

    PubMed  CAS  Google Scholar 

  17. Liu Q, Ning J, Zhang Y, et al (2010) Idiopathic pneumonia syndrome in mice after allogeneic bone marrow transplantation: association between idiopathic pneumonia syndrome and acute graft-versus-host disease. Transpl Immunol 23:12–17

    Article  PubMed  CAS  Google Scholar 

  18. Schwarer AP, Hughes JM, Trotman-Dickenson B, et al (1992) A chronic pulmonary syndrome associated with graft-versus-host disease after allogeneic marrow transplantation. Transplantation 54:1002–1008

    Article  PubMed  CAS  Google Scholar 

  19. Palmas A, Tefferi A, Myers JL, et al (1998) Late-onset noninfectious pulmonary complications after allogeneic bone marrow transplantation. Br J Haematol 100:680–687

    Article  PubMed  CAS  Google Scholar 

  20. Patriarca F, Skert C, Bonifazi F, et al (2006) Effect on survival of the development of late-onset non-infectious pulmonary complications after stem cell transplantation. Haematologica 91:1268–1272

    PubMed  Google Scholar 

  21. Bergeron A, Chevret S, Chagnon K, et al (2011) Prospective evaluation of the incidence, risk factors and clinical outcome of late onset non infectious pulmonary complications after allogeneic hematopoietic stem cell transplantation. Am J Respir Crit Care Med 183:A4667

    Google Scholar 

  22. Duncker C, Dohr D, Harsdorf S, et al (2000) Non-infectious lung complications are closely associated with chronic graftversus-host disease: a single center study of incidence, risk factors and outcome. Bone Marrow Transplant 25:1263–1268

    Article  PubMed  CAS  Google Scholar 

  23. Sakaida E, Nakaseko C, Harima A, et al (2003) Late-onset noninfectious pulmonary complications after allogeneic stem cell transplantation are significantly associated with chronic graftversus-host disease and with the graft-versus-leukemia effect. Blood 102:4236–4242

    Article  PubMed  CAS  Google Scholar 

  24. Huisman C, van der Straaten HM, Canninga-van Dijk MR, et al (2006) Pulmonary complications after T-cell-depleted allogeneic stem cell transplantation: low incidence and strong association with acute graft-versus-host disease. Bone Marrow Transplant 38:561–566

    Article  PubMed  CAS  Google Scholar 

  25. Patriarca F, Skert C, Sperotto A, et al (2004) Incidence, outcome, and risk factors of late-onset noninfectious pulmonary complications after unrelated donor stem cell transplantation. Bone Marrow Transplant 33:751–758

    Article  PubMed  CAS  Google Scholar 

  26. Nusair S, Breuer R, Shapira MY, et al (2004) Low incidence of pulmonary complications following nonmyeloablative stem cell transplantation. Eur Respir J 23:440–445

    Article  PubMed  CAS  Google Scholar 

  27. Au BK, Au MA, Chien JW (2011) Bronchiolitis obliterans syndrome epidemiology after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant 17:1072–1078

    Article  PubMed  Google Scholar 

  28. Filipovich AH, Weisdorf D, Pavletic S, et al (2005) National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant 11:945–956

    Article  PubMed  Google Scholar 

  29. Chien JW, Maris MB, Sandmaier BM, et al (2005) Comparison of lung function after myeloablative and 2 Gy of total body irradiation-based regimens for hematopoietic stem cell transplantation. Biol Blood Marrow Transplant 11:288–296

    Article  PubMed  Google Scholar 

  30. Yoshihara S, Tateishi U, Ando T, et al (2005) Lower incidence of Bronchiolitis obliterans in allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning compared with myeloablative conditioning. Bone Marrow Transplant 35:1195–1200

    Article  PubMed  CAS  Google Scholar 

  31. Chien JW, Duncan S, Williams KM, et al (2010) Bronchiolitis obliterans syndrome after allogeneic hematopoietic stem cell transplantation-an increasingly recognized manifestation of chronic graft-versus-host disease. Biol Blood Marrow Transplant 16: S106–S114

    Article  PubMed  Google Scholar 

  32. Wolff D, Gerbitz A, Ayuk F, et al (2010) Consensus conference on clinical practice in chronic graft-versus-host disease (GVHD): first-line and topical treatment of chronic GVHD. Biol Blood Marrow Transplant 16:1611–1628

    Article  PubMed  Google Scholar 

  33. Bergeron A, Belle A, Chevret S, et al (2007) Combined inhaled steroids and bronchodilatators in obstructive airway disease after allogeneic stem cell transplantation. Bone Marrow Transplant 39:547–553

    Article  PubMed  CAS  Google Scholar 

  34. Bashoura L, Gupta S, Jain A, et al (2008) Inhaled corticosteroids stabilize constrictive bronchiolitis after hematopoietic stem cell transplantation. Bone Marrow Transplant 41:63–67

    Article  PubMed  CAS  Google Scholar 

  35. Norman BC, Jacobsohn DA, Williams KM, et al (2011) Fluticasone, azithromycin and montelukast therapy in reducing corticosteroid exposure in bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: a case series of eight patients. Bone Marrow Transplant 46:1369–1373

    Article  PubMed  CAS  Google Scholar 

  36. Koenecke C, Hertenstein B, Schetelig J, et al (2010) Solid organ transplantation after allogeneic hematopoietic stem cell transplantation: a retrospective, multicenter study of the EBMT. Am J Transplant 10:1897–1906

    Article  PubMed  CAS  Google Scholar 

  37. Sakai R, Kanamori H, Nakaseko C, et al (2011) Air-leak syndrome following allo-SCT in adult patients: report from the Kanto Study Group for Cell Therapy in Japan. Bone Marrow Transplant 46:379–384

    Article  PubMed  CAS  Google Scholar 

  38. Cordier JF (2006) Cryptogenic organising pneumonia. Eur Respir J 28:422–446

    Article  PubMed  Google Scholar 

  39. Freudenberger TD, Madtes DK, Curtis JR, et al (2003) Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood 102:3822–3828

    Article  PubMed  CAS  Google Scholar 

  40. Thirman MJ, Devine SM, O’Toole K, et al (1992) Bronchiolitis obliterans organizing pneumonia as a complication of allogeneic bone marrow transplantation. Bone Marrow Transplant 10:307–311

    PubMed  CAS  Google Scholar 

  41. American Thoracic Society; European Respiratory Society (2002) American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med 165:277–304

    Article  Google Scholar 

  42. Yousem SA (1995) The histological spectrum of pulmonary graft-versus-host disease in bone marrow transplant recipients. Hum Pathol 26:668–675

    Article  PubMed  CAS  Google Scholar 

  43. Bergeron A, Bengoufa D, Feuillet S, et al (2011) The spectrum of lung involvement in collagen vascular-like diseases following allogeneic hematopoietic stem cell transplantation: report of 6 cases and review of the literature. Medicine (Baltimore) 90:146–157

    Article  Google Scholar 

  44. Wagner T, Dhedin N, Philippe B, et al (2006) Acute eosinophilic pneumonia after allogeneic hematopoietic stem cell transplantation. Ann Hematol 85:202–203

    Article  PubMed  Google Scholar 

  45. Yoshimi M, Nannya Y, Watanabe T, et al (2009) Acute eosinophilic pneumonia is a non-infectious lung complication after allogeneic hematopoietic stem cell transplantation. Int J Hematol 89:244–248

    Article  PubMed  Google Scholar 

  46. Parish JM, Muhm JR, Leslie KO (2003) Upper lobe pulmonary fibrosis associated with high-dose chemotherapy containing BCNU for bone marrow transplantation. Mayo Clin Proc 78:630–634

    Article  PubMed  Google Scholar 

  47. Brunet S, Muniz-Diaz E, Baiget M (1994) Chronic eosinophilic pneumonia in a patient treated with allogeneic bone marrow transplantation. Med Clin (Barc) 103:677

    CAS  Google Scholar 

  48. Richard C, Calavia J, Loyola I, et al (1994) Chronic eosinophilic pneumonia in a patient treated with allogenic bone marrow transplantation. Med Clin (Barc) 102:462–464

    CAS  Google Scholar 

  49. Kaplan DH, Anderson BE, McNiff JM, et al (2004) Target antigens determine graft-versus-host disease phenotype. J Immunol 173:5467–5475

    PubMed  CAS  Google Scholar 

  50. Wolff D, Reichenberger F, Steiner B, et al (2002) Progressive interstitial fibrosis of the lung in sclerodermoid chronic graft-versus-host disease. Bone Marrow Transplant 29:357–360

    Article  PubMed  CAS  Google Scholar 

  51. Pihusch R, Salat C, Schmidt E, et al (2002) Hemostatic complications in bone marrow transplantation: a retrospective analysis of 447 patients. Transplantation 74:1303–1309

    Article  PubMed  Google Scholar 

  52. Gerber DE, Segal JB, Levy MY, et al (2008) The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1,514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention. Blood 112:504–510

    Article  PubMed  CAS  Google Scholar 

  53. Pihusch M, Lohse P, Reitberger J, et al (2004) Impact of thrombophilic gene mutations and graft-versus-host disease on thromboembolic complications after allogeneic hematopoietic stem-cell transplantation. Transplantation 78:911–918

    Article  PubMed  CAS  Google Scholar 

  54. Pihusch R, Wegner H, Salat C, et al (2002) Flow cytometric findings in platelets of patients following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 30:381–387

    Article  PubMed  CAS  Google Scholar 

  55. Tichelli A, Gratwohl A (2008) Vascular endothelium as’ novel’ target of graft-versus-host disease. Best Pract Res Clin Haematol 21:139–148

    Article  PubMed  CAS  Google Scholar 

  56. Williams LM, Fussell S, Veith RW, et al (1996) Pulmonary venoocclusive disease in an adult following bone marrow transplantation. Case report and review of the literature. Chest 109:1388–1391

    Article  PubMed  CAS  Google Scholar 

  57. Seguchi M, Hirabayashi N, Fujii Y, et al (2000) Pulmonary hypertension associated with pulmonary occlusive vasculopathy after allogeneic bone marrow transplantation. Transplantation 69:177–179

    Article  PubMed  CAS  Google Scholar 

  58. Mukai M, Kondo M, Bohgaki T, et al (2003) Pulmonary venoocclusive disease following allogeneic peripheral blood stem cell transplantation for chronic myeloid leukaemia. Br J Haematol 123:1

    Article  PubMed  Google Scholar 

  59. Bunte MC, Patnaik MM, Pritzker MR, et al (2008) Pulmonary veno-occlusive disease following hematopoietic stem cell transplantation: a rare model of endothelial dysfunction. Bone Marrow Transplant 41:677–686

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Service de pneumologie, hôpital Saint-Louis, AP-HP, université Paris-Diderot, Sorbonne cité, 1, avenue Claude-Vellefaux, F-75475, Paris cedex 10, France

    F. Schlemmer, G. Lorillon & A. Bergeron

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  1. F. Schlemmer
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  2. G. Lorillon
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  3. A. Bergeron
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Correspondence to A. Bergeron.

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Cet article correspond à la conférence faite par l’auteur au congrès de la SRLF 2012 dans la session : Pathologies de l’allogreffé de moelle.

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Schlemmer, F., Lorillon, G. & Bergeron, A. Les complications pulmonaires non infectieuses de l’allogreffe de cellules souches hématopoïétiques. Réanimation 21 (Suppl 2), 418–425 (2012). https://doi.org/10.1007/s13546-011-0333-4

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