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Rapid lung function decline in post-HSCT BOS patients tied to poor survival outcome

09 May 2019

Lung function is significantly poorer while overall survival (OS) is worse among posthaematopoietic stem cell transplantation (post-HSCT) bronchiolitis obliterans syndrome (BOS) patients with initial rapid lung function decline within 3 months after BOS diagnosis compared to those with initial gradual decline in lung function after diagnosis, according to a study.

Ninety-five (6.5 percent) of 1,461 patients who underwent allogeneic HSCT between 1998 and 2015 were diagnosed with BOS. A matched cohort of HSCT recipients without BOS (n=159) was identified.

Those with a 25-percent decline in FEV1 within the first 3 months after BOS diagnosis were separated into a subgroup with initial rapid decline and another subgroup with initial gradual decline in lung function. Patients in the rapid decline group had lower subsequent lung function parameters and significantly worse OS compared to those in the gradual decline group (p=0.013).

“HSCT BOS patients with rapid initial decline in lung function warrant closer monitoring for the development of other post‐HSCT complications that could affect their survival,” the authors said.

This study compared BOS patients to those without BOS and matched them for age, gender, primary diagnoses, conditioning regimes and chronic graft versus host disease. The authors assessed lung function tests at baseline, at BOS diagnosis and every 3 months after HSCT.

Post-HSCT BOS presents with lung function decline, and the pattern of such a decline after BOS diagnosis could affect prognostications of BOS as a complication after HSCT, according to the authors.

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