Complicações pulmonares não infecciosas tardias após o transplante alogênico de medula óssea

• Ano de defesa: 2006
• Autor(a) principal: Fermino, Fabiana Aidar [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Transplante de medula óssea; Complicações pulmonares não infecciosas tardias; Doença enxerto-versus-hospedeiro pulmonar
• Link de acesso: https://repositorio.unifesp.br/handle/11600/9228

Despite advances in the management of bone marrow transplantation (BMT), pulmonary complications has develop in 40–60% of patients, influencing morbidity and mortalitality. Late-onset noninfectious pulmonary complications (LONIPC) include a number of different entities, an association with chronic graft-versus-host disease (GVHD) has been noted for almost all of them. Among 253 patients who underwent allogeneic BMT at Hospital São Paulo and Hospital Santa Marcelina, 159 patients surviving at least 6 months, 16 (10%) fulfilled the diagnostic criteria of LONIPC. Clinical, radiologic, pulmonary function and pathologic tests were performed to identify this cases and exclude an infectious cause for the symptoms. The majority of patients responded well to tratment with ciclosporine and prednisone. There was a significantly association between pulmonary infectious (p=0.01), acute and chronic GVHD and the development of LONIPC (p=0.038 and 0.043, respectively). The frequency of Tuberculosis (Tb) among our patients was 3.7%. Two (33%) of six patients with Tb fulfilled criteria for LONIPC. At first, we decided exclude this cases. However, if this patients were included on LONIPC group, the frequency of Tb will be 11.1% among this patients. Despite this frequency was high as compared with patients without LONIPC (2%), the association was not statistically significantly. These results have implications for the care of pacients who developed respiratory symptoms after BMT. In addition to corroborating previously reported studies, we found acute and chronic GVHD are associated with LONIPC and an incidence of 10%.