Bronchiolitis obliterans after allo-SCT: clinical criteria and treatment options

Bronchiolitis obliterans (BO) following allogeneic haemato-poietic SCT (HSCT) is a serious complication affecting1.7–26% of the patients, with a reported mortality rate of21–100%. It is considered a manifestation of chronic graft-versus-host disease, but our knowledge of aetiology andpathogenesis is still limited. Diagnostic criteria are beingdeveloped, and will allow more uniform and comparableresearch activities between centres. At present, no rando-mised controlled trials have been completed that coulddemonstrate an effective treatment. Steroids in combinationwith other immunosuppressive drugs still constitute thebackbone of the treatment strategy, and results from our andother centres suggest that monthly infusions of high-dosepulse i.v. methylprednisolone (HDPM) might stabilise thedisease and hinder progression. This article provides anoverview of the current evidence regarding treatment optionsfor BO and presents the treatment results with HDPM in apaediatric national HSCT-cohort.Bone Marrow Transplantation (2012) 47, 1020–1029;doi:10.1038/bmt.2011.161; published online 29 August 2011Keywords: