Time to Rethink Bronchiolitis Obliterans Syndrome Following Lung or Hematopoietic Cell Transplantation in Pediatric Patients.
Simple Summary: Bronchitis obliterans syndrome (BOS) may occur following lung transplantation (LTx) or hematopoietic cell transplantation (HCT). The primary issue is graft-versus-host disease, complicating diagnosis. Treatment is based on empirical evidence and interdisciplinary knowledge. Recent ad...
| Publicado en: | Cancers Vol. 16; no. 21; pp. 3715 - 3730 |
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| Autores principales: | , , |
| Formato: | review tables/charts Journal Article |
| Publicado: |
MDPI
Nov2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=180784749&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 180784749 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726694 B74B jtl: Cancers issn: 20726694 maglogo: N pubinfo: dt: Nov2024 vid: 16 iid: 21 pid: 97109 pub: MDPI artinfo: ui: 180784749 180784749 180784749 10.3390/cancers16213715 180784749 ppf: 3715 ppct: 15 formats: tig: atl: Time to Rethink Bronchiolitis Obliterans Syndrome Following Lung or Hematopoietic Cell Transplantation in Pediatric Patients. aug: au: Jaing, Tang-Her Wang, Yi-Lun Chiu, Chia-Chi affil: Division of Hematology and Oncology, Department of Pediatrics, Chang Gung Memorial Hospital, 5 Fu-Shin Street, Kwei-Shan, Taoyuan 33315, Taiwan sug: subj: Hematopoietic Stem Cell Transplantation Adverse Effects Lung Transplantation Adverse Effects Pediatric Care Bronchiolitis Obliterans Syndrome Risk Factors Bronchiolitis Obliterans Syndrome Therapy Allografts Adverse Effects Graft Versus Host Disease Etiology Lung Physiology Bronchiolitis Obliterans Syndrome Diagnosis Risk Assessment Bronchiolitis Obliterans Syndrome Symptoms Bronchiolitis Obliterans Syndrome Physiopathology Learning Algorithms Immunosuppression Cyclosporine Therapeutic Use Janus Kinase Inhibitors Therapeutic Use Antifibrotic Agents Therapeutic Use B Lymphocytes Cell Therapy Methods ab: Simple Summary: Bronchitis obliterans syndrome (BOS) may occur following lung transplantation (LTx) or hematopoietic cell transplantation (HCT). The primary issue is graft-versus-host disease, complicating diagnosis. Treatment is based on empirical evidence and interdisciplinary knowledge. Recent advances emphasize understanding the etiology, clinical features, and pathobiology of BOS, fostering cross-disciplinary knowledge. Treatment algorithms are based on thorough research and expert clinical insights, with new therapies being explored to enhance survival rates and prevent LTx or re-transplantation. Background: Similar in histological characteristics and clinical manifestations, bronchiolitis obliterans syndrome (BOS) can develop following lung transplantation (LTx) or hematopoietic cell transplantation (HCT). In contrast to lung transplantation, where BOS is restricted to the lung allograft, HCT-related systemic graft-versus-host disease (GVHD) is the root cause of BOS. Because lung function declines following HCT, diagnosis becomes more difficult. Given the lack of proven effective medicines, treatment is based on empirical evidence. Methods: Cross-disciplinary learning is crucial, and novel therapies are under investigation to improve survival and avoid LTx. Recent advances have focused on updating the understanding of the etiology, clinical features, and pathobiology of BOS. It emphasizes the significance of learning from experts in other transplant modalities, promoting cross-disciplinary knowledge. Results: Our treatment algorithms are derived from extensive research and expert clinical input. It is important to ensure that immunosuppression is optimized and that any other conditions or contributing factors are addressed, if possible. Clear treatment algorithms are provided for each condition, drawing from the published literature and consensus clinical opinion. There are several novel therapies currently being investigated, such as aerosolized liposomal cyclosporine, Janus kinase inhibitors, antifibrotic therapies, and B-cell-directed therapies. Conclusions: We urgently need innovative treatments that can greatly increase survival rates and eliminate the need for LTx or re-transplantation. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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