Abstract:

Objective To analyse the clinical characteristics and risk factors of occlusive bronchiolitis obliterans syndrome (BOS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children in order to further optimize the treatment protocol.Methods Clinical data of children who received allo-HSCT from October 2010 to December 2018 at Children's Hospital of Soochow University were retrospectively analysed. Results A total of 351 children were included, 213 males and 138 females. Until September 1, 2019, a total of 29 (8.3%) children developed BOS, 11 males and 18 females, with a median age of 92.0 (67.0-132.0) months. The median time from transplantation to the development of BOS was 10.0 (8.5-20.0) months. The cumulative incidence of BOS at 1, 2, and 3 years after transplantation was (6.0±1.3)%, (10.0±1.8)%, and (10.7±2.0)%, respectively. 28 of the 29 children with BOS had comorbidities with chronic graft-versus-host disease (cGVHD) in other target organs prior to the onset of BOS. The results of multifactorial logistic regression analysis showed that older age, female gender, respiratory disease within 100 days after transplantation, and comorbidities with other target organ cGVHD were independent risk factors for the development of BOS (P<0.05). Conclusion BOS is a serious complication after HSCT. Children who were female, older, had a combination of other target organ cGVHD, and had respiratory disease within 100 days of transplantation were at greater risk of developing BOS.

Key words: hematopoietic stem cell transplantation, bronchiolitis obliterans syndrome, graft-versus-host disease, child