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Allografting

Air-leak syndrome following allo-SCT in adult patients: report from the Kanto Study Group for Cell Therapy in Japan

Bone Marrow Transplantation volume 46, pages 379–384 (2011)Cite this article

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Abstract

We retrospectively investigated air-leak syndrome (ALS), including pneumothorax and mediastinal/s.c. emphysema, following allogeneic hematopoietic SCT. Eighteen patients (1.2%) developed ALS among 1515 undergoing SCT between 1994 and 2005 at the nine hospitals participating in the Kanto Study Group on Cell Therapy. The median onset of ALS was at 575 days (range: 105–1766) after SCT and 14 patients (77.8%) had experienced late onset noninfectious pulmonary complications (LONIPC) before ALS. Chronic GVHD (cGVHD) was the strongest risk factor for ALS (odds ratio 13.5, P=0.013 by multivariate analysis). Repeat SCT, male sex and age <38 years at the time of transplantation were also significant risk factors for ALS. Patients with ALS had a significantly worse survival rate than those without ALS (61.5 vs 14.9% at 3 years; P=0.000). The main cause of death was respiratory complications in 8 of the 18 patients. In conclusion, ALS is a rare complication of SCT that is more likely to occur in relatively young male patients with cGVHD and/or LONIPC. It is possible that better understanding and treatment of LONIPC may lead to prevention of ALS.

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Acknowledgements

We thank Satoshi Morita and Tetsuji Kaneko from Yokohama City University Medical Center for the expert statistical advice. We also thank all of the dedicated physicians and paramedical staff at the participating transplantation centers who contributed data to this study.

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Authors and Affiliations

  1. Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan

    R Sakai, H Kanamori & A Maruta

  2. Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan

    R Sakai & S Fujisawa

  3. Department of Hematology, Chiba University Graduate School of Medicine, Chiba, Japan

    C Nakaseko

  4. Department of Hematology and Oncology, Tokai University School of Medicine, Kanagawa, Japan

    F Yoshiba

  5. Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    K Fujimaki

  6. Leukemia Research Center, Saiseikai Maebashi Hospitals, Maebashi, Japan

    T Sakura

  7. Department of Hematology, Saitama Medical University, Saitama, Japan

    N Kawai

  8. Department of Internal Medicine, Chiba Municipal Aoba Hospital, Chiba, Japan

    M Onoda

  9. Department of Medicine and Clinical Science, Gunma University Graduate School of Medicine, Gunma, Japan

    T Matsushima

  10. Division of Hematology, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    H Sakamaki

  11. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan

    S Okamoto

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  1. R Sakai
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  2. H Kanamori
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  3. C Nakaseko
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  4. F Yoshiba
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  6. T Sakura
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  7. S Fujisawa
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  8. N Kawai
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  10. T Matsushima
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  11. A Maruta
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  12. H Sakamaki
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  13. S Okamoto
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for the Kanto Study Group for Cell Therapy (KSGCT)

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Correspondence to R Sakai.

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The authors declare no conflict of interest.

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Sakai, R., Kanamori, H., Nakaseko, C. et al. Air-leak syndrome following allo-SCT in adult patients: report from the Kanto Study Group for Cell Therapy in Japan. Bone Marrow Transplant 46, 379–384 (2011). https://doi.org/10.1038/bmt.2010.129

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  • DOI: https://doi.org/10.1038/bmt.2010.129

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