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Risk factors for interstitial pneumonia following bone marrow transplantation for severe aplastic anaemia.
- Source :
-
British journal of haematology [Br J Haematol] 1989 Apr; Vol. 71 (4), pp. 535-43. - Publication Year :
- 1989
-
Abstract
- Data from 547 patients with aplastic anaemia who received bone marrow transplants from HLA-identical siblings were analysed to determine factors associated with the risk of interstitial pneumonia (IPn). IPn developed in 92 patients (17%). 37% of cases were associated with cytomegalovirus infection and 22% with other organisms; in 41% of cases no organism was identified. The case fatality rate was 64%; the mortality rate due to IPn was 11%. In multivariate analysis, four factors were associated with an increased probability of interstitial pneumonia: use of methotrexate rather than cyclosporine after transplantation (relative risk, 2.8; P less than 0.0008); occurrence of moderate to severe acute graft-versus-host disease (relative risk, 2.2; P less than 0.002); inclusion of total body radiation in the pretransplant preparative regimen (relative risk 2.2, P less than 0.004); and patient age greater than 20 (relative risk 1.7, P less than 0.002). The probability of IPn ranged from 4% for patients with none of these adverse risk factors to 51% (relative risk of 13.4) for patients with all four. The incidence of IPn decreased significantly between 1978 and 1985, paralleling a decrease in the use of total body radiation pretransplant for immune suppression and methotrexate post-transplant for prophylaxis against graft-versus-host disease.
- Subjects :
- Adolescent
Adult
Anemia, Aplastic complications
Anemia, Aplastic mortality
Child
Child, Preschool
Female
Graft vs Host Disease drug therapy
Graft vs Host Disease etiology
Humans
Infant
Male
Methotrexate adverse effects
Middle Aged
Pulmonary Fibrosis mortality
Radiotherapy adverse effects
Risk Factors
Anemia, Aplastic therapy
Bone Marrow Transplantation
Postoperative Complications etiology
Pulmonary Fibrosis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 0007-1048
- Volume :
- 71
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- British journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 2653409
- Full Text :
- https://doi.org/10.1111/j.1365-2141.1989.tb06314.x