Skip to main content
SpringerLink
Log in

Long Term Survivors of Hematopoietic Stem Cell Transplantation: The Role of the Pulmonologist

  • Chapter
  • First Online:
Pulmonary and Critical Care Considerations of Hematopoietic Stem Cell Transplantation

Abstract

The pulmonologist plays an important role in the long-term care of HSCT survivors, which include (1) providing expert consultation for the diagnosis and management of late-onset lung complications in the multidisciplinary care of HSCT survivors; (2) providing education to posttransplant care providers regarding early recognition of noninfectious lung disease, particularly bronchiolitis obliterans syndrome, including advocacy of and access to PFT screening; and (3) advancing the scientific agenda toward understanding of late-onset lung complications.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M, et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med. 2010;363(22):2091–101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. McDonald GB, Sandmaier BM, Mielcarek M, Sorror M, Pergam SA, Cheng GS, et al. Survival, nonrelapse mortality, and relapse-related mortality after allogeneic hematopoietic cell transplantation: comparing 2003-2007 versus 2013-2017 cohorts. Ann Intern Med. 2020;172(4):229–39.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Panoskaltsis-Mortari A, Griese M, Madtes DK, Belperio JA, Haddad IY, Folz RJ, et al. An official American Thoracic Society research statement: noninfectious lung injury after hematopoietic stem cell transplantation: idiopathic pneumonia syndrome. Am J Respir Crit Care Med. 2011;183(9):1262–79.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Barker AF, Bergeron A, Rom WN, Hertz MI. Obliterative bronchiolitis. N Engl J Med. 2014;370(19):1820–8.

    Article  CAS  PubMed  Google Scholar 

  5. Schlemmer F, Chevret S, Lorillon G, De Bazelaire C, Peffault de Latour R, Meignin V, et al. Late-onset noninfectious interstitial lung disease after allogeneic hematopoietic stem cell transplantation. Respir Med. 2014;108(10):1525–33.

    Article  PubMed  Google Scholar 

  6. Bergeron A, Cheng GS. Bronchiolitis obliterans syndrome and other late pulmonary complications after allogeneic hematopoietic stem cell transplantation. Clin Chest Med. 2017;38(4):607–21.

    Article  PubMed  Google Scholar 

  7. Jagasia MH, Greinix HT, Arora M, Williams KM, Wolff D, Cowen EW, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. the 2014 diagnosis and staging working group report. Biol Blood Marrow Transplant. 2015;21(3):389–401. e1

    Article  PubMed  Google Scholar 

  8. Wolff D, Radojcic V, Lafyatis R, Cinar R, Rosenstein RK, Cowen EW, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IV. The 2020 highly morbid forms report. Transplant Cell Ther. 2021;27(10):817–35.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Glanville AR. Bronchiolitis obliterans syndrome after lung or haematopoietic stem cell transplantation: current management and future directions. ERJ Open Res. 2022;8:00185–2022.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chow EJ, Cushing-Haugen KL, Cheng GS, Boeckh M, Khera N, Lee SJ, et al. Morbidity and mortality differences between hematopoietic cell transplantation survivors and other cancer survivors. J Clin Oncol. 2017;35(3):306–13.

    Article  PubMed  Google Scholar 

  11. Bergeron A, Chevret S, Peffault de Latour R, Chagnon K, de Margerie-Mellon C, Riviere F, et al. Noninfectious lung complications after allogeneic haematopoietic stem cell transplantation. Eur Respir J. 2018;51(5):1702617.

    Article  PubMed  Google Scholar 

  12. Arai S, Arora M, Wang T, Spellman SR, He W, Couriel DR, et al. Increasing incidence of chronic graft-versus-host disease in allogeneic transplantation: a report from the center for international blood and marrow transplant research. Biol Blood Marrow Transplant. 2015;21(2):266–74.

    Article  PubMed  Google Scholar 

  13. Foord AM, Cushing-Haugen KL, Boeckh MJ, Carpenter PA, Flowers MED, Lee SJ, et al. Late infectious complications in hematopoietic cell transplantation survivors: a population-based study. Blood Adv. 2020;4(7):1232–41.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Cheng GS, Storer B, Chien JW, Jagasia M, Hubbard JJ, Burns L, et al. Lung function trajectory in bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplant. Ann Am Thorac Soc. 2016;13(11):1932–9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Bondeelle L, Bergeron A. Managing pulmonary complications in allogeneic hematopoietic stem cell transplantation. Expert Rev Respir Med. 2019;13(1):105–19.

    Article  CAS  PubMed  Google Scholar 

  16. Palmer J, Williams K, Inamoto Y, Chai X, Martin PJ, Tomas LS, et al. Pulmonary symptoms measured by the national institutes of health lung score predict overall survival, nonrelapse mortality, and patient-reported outcomes in chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2014;20(3):337–44.

    Article  PubMed  Google Scholar 

  17. Paczesny S, Hakim FT, Pidala J, Cooke KR, Lathrop J, Griffith LM, et al. National institutes of health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: III. The 2014 biomarker working group report. Biol Blood Marrow Transplant. 2015;21(5):780–92.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Bergeron A, Godet C, Chevret S, Lorillon G, Peffault de Latour R, de Revel T, et al. Bronchiolitis obliterans syndrome after allogeneic hematopoietic SCT: phenotypes and prognosis. Bone Marrow Transplant. 2013;48(6):819–24.

    Article  CAS  PubMed  Google Scholar 

  19. Wan ES, Balte P, Schwartz JE, Bhatt SP, Cassano PA, Couper D, et al. Association between preserved ratio impaired spirometry and clinical outcomes in US adults. JAMA. 2021;326(22):2287–98.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Freudenberger TD, Madtes DK, Curtis JR, Cummings P, Storer BE, Hackman RC. Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood. 2003;102(10):3822–8.

    Article  CAS  PubMed  Google Scholar 

  21. Kitko CL, Pidala J, Schoemans HM, Lawitschka A, Flowers ME, Cowen EW, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: IIa. The 2020 clinical implementation and early diagnosis working group report. Transplant Cell Ther. 2021;27(7):545–57.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Jamani K, He Q, Liu Y, Davis C, Hubbard J, Schoch G, et al. Early post-transplantation spirometry is associated with the development of bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2019;26(5):943–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Duque-Afonso J, Ihorst G, Waterhouse M, Zeiser R, Wasch R, Bertz H, et al. Impact of lung function on bronchiolitis obliterans syndrome and outcome after allogeneic hematopoietic cell transplantation with reduced-intensity conditioning. Biol Blood Marrow Transplant. 2018;24(11):2277–84.

    Article  PubMed  Google Scholar 

  24. Sheshadri A, Alousi A, Bashoura L, Stolar K, Baghaie S, Arain MH, et al. Feasibility and reliability of home-based spirometry telemonitoring in allogeneic hematopoietic cell transplant recipients. Ann Am Thorac Soc. 2020;17:1329.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Turner J, He Q, Baker K, Chung L, Lazarevic-Fogelquist A, Bethune D, et al. Home spirometry telemonitoring for early detection of bronchiolitis obliterans syndrome in patients with chronic graft-versus-host disease. Transplant Cell Ther. 2021;27(7):616.e1–6.

    Article  PubMed  Google Scholar 

  26. Nathan SD, Shlobin OA, Reese E, Ahmad S, Fregoso M, Athale C, et al. Prognostic value of the 6 min walk test in bronchiolitis obliterans syndrome. Respir Med. 2009;103(12):1816–21.

    Article  PubMed  Google Scholar 

  27. Fakhro M, Ingemansson R, Algotsson L, Lindstedt S. Impact of forced expiratory volume in 1 second (FEV1) and 6-minute walking distance at 3, 6, and 12 months and annually on survival and occurrence of bronchiolitis obliterans syndrome (BOS) after lung transplantation. Ann Transplant. 2017;22:532–40.

    Article  CAS  PubMed  Google Scholar 

  28. Belloli EA, Degtiar I, Wang X, Yanik GA, Stuckey LJ, Verleden SE, et al. Parametric response mapping as an imaging biomarker in lung transplant recipients. Am J Respir Crit Care Med. 2017;195(7):942–52.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Belloli EA, Gu T, Wang Y, Vummidi D, Lyu DM, Combs MP, et al. Radiographic graft surveillance in lung transplantation: prognostic role of parametric response mapping. Am J Respir Crit Care Med. 2021;204(8):967–76.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Cheng GS, Selwa KE, Hatt C, Ram S, Fortuna AB, Guerriero M, et al. Multicenter evaluation of parametric response mapping as an indicator of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Am J Transplant. 2020;20:2198.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Galban CJ, Boes JL, Bule M, Kitko CL, Couriel DR, Johnson TD, et al. Parametric response mapping as an indicator of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2014;20(10):1592–8.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Walkup LL, Roach DJ, Hall CS, Gupta N, Thomen RP, Cleveland ZI, et al. Cyst ventilation heterogeneity and alveolar airspace dilation as early disease markers in lymphangioleiomyomatosis. Ann Am Thorac Soc. 2019;16(8):1008–16.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sharifi H, Lai YK, Guo H, Hoppenfeld M, Guenther ZD, Johnston L, et al. Machine learning algorithms to differentiate among pulmonary complications after hematopoietic cell transplant. Chest. 2020;158:1090.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bergeron A, Chevret S, Chagnon K, Godet C, Bergot E, Peffault de Latour R, et al. Budesonide/formoterol for bronchiolitis obliterans after hematopoietic stem cell transplantation. Am J Respir Crit Care Med. 2015;191(11):1242–9.

    Article  CAS  PubMed  Google Scholar 

  35. Norman BC, Jacobsohn DA, Williams KM, Au BK, Au MA, Lee SJ, et al. 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. 2011;46(10):1369–73.

    Article  CAS  PubMed  Google Scholar 

  36. Williams KM, Cheng GS, Pusic I, Jagasia M, Burns L, Ho VT, et al. Fluticasone, azithromycin, and montelukast treatment for new-onset bronchiolitis obliterans syndrome after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2016;22(4):710–6.

    Article  CAS  PubMed  Google Scholar 

  37. Penack O, Marchetti M, Ruutu T, Aljurf M, Bacigalupo A, Bonifazi F, et al. Prophylaxis and management of graft versus host disease after stem-cell transplantation for haematological malignancies: updated consensus recommendations of the European Society for Blood and Marrow Transplantation. Lancet Haematol. 2020;7(2):e157–e67.

    Article  PubMed  Google Scholar 

  38. Bergeron A, Chevret S, Granata A, Chevallier P, Vincent L, Huynh A, et al. Effect of azithromycin on airflow decline-free survival after allogeneic hematopoietic stem cell transplant: the ALLOZITHRO randomized clinical trial. JAMA. 2017;318(6):557–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Cheng GS, Bondeelle L, Gooley T, He Q, Jamani K, Krakow EF, et al. Azithromycin use and increased cancer risk among patients with bronchiolitis obliterans after hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2020;26(2):392–400.

    Article  CAS  PubMed  Google Scholar 

  40. Yadav H, Peters SG, Keogh KA, Hogan WJ, Erwin PJ, West CP, et al. Azithromycin for the treatment of obliterative bronchiolitis after hematopoietic stem cell transplantation: a systematic review and meta-analysis. Biol Blood Marrow Transplant. 2016;22(12):2264–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Matthaiou EI, Sharifi H, O'Donnell C, Chiu W, Owyang C, Chatterjee P, et al. The safety and tolerability of pirfenidone for bronchiolitis obliterans syndrome after hematopoietic cell transplant (STOP-BOS) trial. Bone Marrow Transplant. 2022;57:1319.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Perch M, Besa V, Corris PA, Iversen M, Kneidinger N, Leuckfeld I, et al. A European multi-center, randomized, double-blind trial of Pirfenidone in bronchiolitis-obliterans-syndrome grade 1-3 in lung transplant recipients (European trial of Pirfenidone in BOS (EPOS)). J Heart Lung Transplant. 2020;39(4S):S12.

    Article  Google Scholar 

  43. Tran J, Norder EE, Diaz PT, Phillips GS, Elder P, Devine SM, et al. Pulmonary rehabilitation for bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2012;18(8):1250–4.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Choi HE, Lim SN, Lee JH, Park SH. Comprehensive pulmonary rehabilitation in patients with bronchiolitis obliterans syndrome: a case series. Respir Med Case Rep. 2020;31:101161.

    PubMed  PubMed Central  Google Scholar 

  45. Cheng GS, Edelman JD, Madtes DK, Martin PJ, Flowers ME. Outcomes of lung transplantation after allogeneic hematopoietic stem cell transplantation. Biol Blood Marrow Transplant. 2014;20(8):1169–75.

    Article  PubMed  Google Scholar 

  46. Greer M, Berastegui C, Jaksch P, Benden C, Aubert J, Roux A, et al. Lung transplantation after allogeneic stem cell transplantation: a pan-European experience. Eur Respir J. 2018;51(2):1701330.

    Article  PubMed  Google Scholar 

  47. Leard LE, Holm AM, Valapour M, Glanville AR, Attawar S, Aversa M, et al. Consensus document for the selection of lung transplant candidates: an update from the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2021;40(11):1349–79.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Cuvelier GDE, Nemecek ER, Wahlstrom JT, Kitko CL, Lewis VA, Schechter T, et al. Benefits and challenges with diagnosing chronic and late acute GVHD in children using the NIH consensus criteria. Blood. 2019;134(3):304–16.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Uhlving HH, Bang CL, Christensen IJ, Buchvald F, Nielsen KG, Heilmann CJ, et al. Lung function after allogeneic hematopoietic stem cell transplantation in children: a longitudinal study in a population-based cohort. Biol Blood Marrow Transplant. 2013;19(9):1348–54.

    Article  PubMed  Google Scholar 

  50. Walther S, Rettinger E, Maurer HM, Pommerening H, Jarisch A, Sorensen J, et al. Long-term pulmonary function testing in pediatric bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. Pediatr Pulmonol. 2020;55(7):1725–35.

    Article  PubMed  Google Scholar 

  51. Srinivasan A, Sunkara A, Mitchell W, Sunthankar S, Kang G, Stokes DC, et al. Recovery of pulmonary function after allogeneic hematopoietic cell transplantation in children is associated with improved survival. Biol Blood Marrow Transplant. 2017;23(12):2102–9.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Tamburro RF, Cooke KR, Davies SM, Goldfarb S, Hagood JS, Srinivasan A, et al. Pulmonary complications of pediatric hematopoietic cell transplantation. A National Institutes of Health workshop summary. Ann Am Thorac Soc. 2021;18(3):381–94.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Research Division, Fred Hutchinson Cancer Center and Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Guang-Shing Cheng

Authors
  1. Guang-Shing Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guang-Shing Cheng .

Editor information

Editors and Affiliations

  1. Pulmonary and Critical Care Medicine, Wayne State University, Detroit, MI, USA

    Ayman O. Soubani

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Cheng, GS. (2023). Long Term Survivors of Hematopoietic Stem Cell Transplantation: The Role of the Pulmonologist. In: Soubani, A.O. (eds) Pulmonary and Critical Care Considerations of Hematopoietic Stem Cell Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-031-28797-8_37

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-28797-8_37

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28796-1

  • Online ISBN: 978-3-031-28797-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation