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전윤홍,원설믜,김환수,이재욱,윤종서,정낙균,조빈,김현희,김진택 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.0
The success of allogeneic hematopoietic stem cell transplantation(HSCT) is often restricted by pulmonary complications(PCs). The object of this study is to investigate the prevalence and perceived timeline of PCs following allogeneic HSCT according to infectious and non-infectious origins in children. A retrospective chart review of 174 pediatric patients of aged between 4 to 28 years, receiving allogeneic HSCT between 2009 and 2012 was performed. We compared demographic and pretransplant data of patients with PCs according to the infectious and noninfectious origins. Eighty three PCs developed in 66 patients(37.9%): 57 infectious(24.7%), 26 noninfectious(14.9%), and 3 both infectious and noninfectious(1.7%). The cumulative incidence of infectious PCs was increased earlier than noninfectious PCs after HSCT(p=0.027). The main infectious PCs were unspecified pneumonia(18 [10.3%]), fungal pneumonia(14 [8%]), acute bronchitis(7 [4%]) and viral pneumonia(7 [4%]). Bronchiolitis obliterans, air trapping, cryptogenic organizing pneumonia were the common noninfectious complications. Independent factors associated with PCs included cell source of HSCT and severity of chronic GVHD(p<0.001). The mortality risk following noninfectious PCs was much increased during the first year and relatively stable thereafter. Whereas, the mortality risk following infectious PCs showed continuous increase until second year. The infectious PCs were more prevalent and occurred earlier than noninfectious PCs. The development of infectious complications was more related to decreased survival.
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