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The following is a summary of “Clinical impact of airflow obstruction after allogeneic hematopoietic stem cell transplantation,” published in the August 2024 issue of Hematology by Nakao et al.

Criteria for airflow obstruction (AFO) 1 year after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in pulmonary function tests (PFTs) were more stringent than the bronchiolitis obliterans syndrome (BOS) criteria set by the National Institutes of Health.

Researchers conducted a retrospective study evaluating the clinical impact of the AFO criteria when applied at any time after transplantation.

They reviewed data from 132 patients who underwent allo-HSCT (2006 and 2016). The study assessed the cumulative incidence of AFO, time to AFO diagnosis, and its association with chronic graft-vs.-host disease (cGVHD) and non-relapse mortality.

The results showed that the 2-year cumulative incidence of AFO was 35.0%, with a median time to diagnosis of 101 days after transplantation (35–716 days). Patients with AFO had a significantly higher incidence of overall cGVHD compared to those without AFO (80.4% vs. 47.7%, P<0.01), with 37.0% of patients with AFO developing cGVHD after AFO diagnosis. The 5-year cumulative incidence of BOS after AFO onset was 49.1%. Additionally, the 5-year cumulative incidence of non-relapse mortality was higher in the AFO group than in the non-AFO group (24.7% vs. 7.1%, P<0.01).

They concluded that close monitoring of PFTs within the first two years after allo-HSCT, regardless of cGVHD status, was essential for early AFO detection and preventing progression to BOS.

Source: link.springer.com/article/10.1007/s12185-024-03831-y