Çocuklarda Kök Hücre Nakli Sonrası Gelişen Pulmoner Komplikasyonlar

Abstract

Çocuklarda kök hücre nakli sonrası gelişen pulmoner komplikasyonlar (PK) önemli bir morbitide ve mortalite nedenidir. Enfeksiyöz PK’ların nonenfeksiyöz PK’dan ayrımının yapılması uygun tedavi seçeneği için önemlidir. Pediatrik ve erişkin çalışmalarında enfeksiyon nedenli PK’ın sıklığının yüksek olduğu bilinmesine rağmen, profilaktik antibiyotik kullanımı nonenfeksiyöz nedenlerin ağırlık kazanmasına yol açmaktadır. Allogeneik nakil yapılan bu hastalarda erken tanı ve tedavi ile PK morbitide ve mortalitesi azalmaktadır.

Keywords

• Kök hücre nakli, pulmoner komplikasyonlar

PULMONARY COMPLICATIONS AFTER STEM CELL TRANSPLANTATION IN CHILDREN

Abstract

Pulmonary complications (PCs) are major causes of morbidity and mortality after stem cell transplantation (SCT) in children. Differentiating infectious from noninfectious PCs is difficult but critical for proper treatment. Most of the studies, including pediatric and adult patients, infectious aetiology is mare comman. Howerver, the increased use of prophylactic antibiotics has shifted the spectrum towards noninfectious causes. The patients undergoing allogeneic SCT must be dianosed eary and treated aggresively to diminish the morbidity and mortality associated with PCs

Keywords

• Stem cell transplantation, pulmonary complications

References

1. Krowka MJ, Rosenow EC 3rd, Hoagland HC. Pulmonary comp- lications of bone marrow transplantation. Chest 1985; 87: 237
2. Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med 2004;170: 22 - 48.
3. Michelson PH, Goyal R, Kurland G. Pulmonary Complications of haematopoietic cell transplantation in children. Paediatr Respir Rev 2007; 8: 46 - 61.
4. Gower WA, Collaco JM, Mogayzel PJ Jr. Pulmonary dysfuncti- on in pediatric hematopoietic stem cell transplant patients: non- infectious and long term complications.Pediatr Blood Cancer ; 49: 225 - 233
5. Eikenberry M, Bartakova H, Defor T, Haddad IY, Ramsay NK, Blazar BR, Milla CE, Cornfield DN. Natural history of pulmo- nary complications in children after bone marrow transplantation. Biol Blood Marrow Transplant 2005; 11: 56 - 64.
6. Griese M, Rampf U, Hofmann D, Führer M, Reinhardt D, Bender- Götze C. Pulmonary complications after bone marrow transplan- tation in children:twenty four years of experience in a single pedi- atric center. Pediatr Pulmonol 2000; 30: 393 - 401.
7. Gladwin MT, Sachdev V, Jison ML, Shizukuda Y, Plehn JF, Minter K, Brown B, Coles WA, Nichols JS, Ernst I, Hunter LA, Black- welder WC, Schechter AN, Rodgers GP, Castro O, Ognibene FP. Pulmonary hypertension as a risk factor for death in patients with sickle cell disease. N Engl J Med 2004; 350: 886 - 895.
8. Hoover M, Morgan ER, Kletzel M. Prior fungal infection is not a contraindication to bone marrow transplant in patients with acute leukemia.Med Pediatr Oncol 1997; 28: 268 - 273.

9. Smith TJ, Rothenberg SS, Brooks M, Bealer J, Chang J, Cook BA, Cullen JW. Thoracoscopic surgery in childhood cancer. J Pediatr Hematol Oncol 2002; 24: 429 - 435.
10. White M, Murphy AJ, Hastings Y, Shergold J, Young J, Montgo- mery C, Davies PS, Lockwood L. Nutritional status and energy expenditure in children pre-bone marrow transplant. Bone Mar- row Transplant 2005; 35: 775 - 779.
11. Busca A, Saroglia EM, Giacchino M, Vai S, Vassallo E, Fagioli F, Linari A, Dotti G, Miniero R, Madon E. Analysis of early infecti- ous complications in pediatric patients undergoing bone marrow transplantation. Support Care Cancer 1999; 7: 253 - 259.
12. Mullen CA, Nair J, Sandesh S, Chan KW. Fever and neutropenia in pediatric hematopoietic stem cell transplant patients. Bone Mar- row Transplant 2000; 25: 59 - 65.
13. Laws HJ, Kobbe G, Dilloo D, Dettenkofer M, Meisel R, Geisel R, Haas R, Göbel U, Schulze-Röbbecke R. Surveillance of no- socomial infections in paediatric recipients of bone marrow or peripheral blood stem cell transplantation during neutropenia, compared with adult recipients. J Hosp Infect 2006; 62: 80 - 88.
14. Krüger W, Rüssmann B, Kröger N, Salomon C, Ekopf N, Els- ner HA, Kaulfers PM, Mack D, Fuchs N, Dürken M, Kabisch H, Erttmann R, Zander AR. Early infections in patients undergoing bone marrow or blood stem cell transplantation- a 7 year single centre investigation of 409 cases. Bone Marrow Transplant 1999; : 589 – 597.
15. Ewig S, Torres A, Riquelme R, El-Ebiary M, Rovira M, Carreras E, Rano A, Xaubet A. Pulmonary Complications in patients with haematological malignancies treated at a respiratory ICU. Eur Res- pir J 1998; 12: 116 - 122.
16. Marr KA, Seidel K, White TC, Bowden RA. Candidemia in allo- geneic blood and marrow transplant recipients: evolution of risk factors after the adoption of prophylactic fluconazole. J Infect Dis 2000;181:309 - 316.
17. Boeckh M, Nichols WG, Papanicolaou G, Rubin R, Wingard JR, Zaia J. Cytomegalovirus in hematopoietic stem cell transplant re- cipients: Current status, known challenges, and future strategies. Biol Blood Marrow Transplant 2003; 9: 543 - 558.
18. Watzinger F, Suda M, Preuner S, Baumgartinger R, Ebner K, Bas- kova L, Niesters HG, Lawitschka A, Lion T. Real time quantitative PCR assays for detection and monitoring of pathogenic human viruses in immunosuppresed pediatric patients. J Clin Microbiol ; 42: 5189 – 5198.
19. Nash RA, Dansey R, Storek J, Georges GE, Bowen JD, Holmberg LA, Kraft GH, Mayes MD, McDonagh KT, Chen CS, Dipersio J, Lemaistre CF, Pavletic S, Sullivan KM, Sunderhaus J, Furst DE, McSweeney PA. Epstein-Barr virus associated posttransplantation lymphoproliferative disorder after high dose immunosuppressive therapy and autologous CD34-selected hematopoietic stem cell transplantation for severe autoimmune diseases. Biol Blood Mar- row Transplant 2003; 9: 583 - 591.
20. Han CS, Miller W, Haake R, Weisdorf D. Varicella zoster infecti- on after bone marrow transplantation: incidence, risk factors and complications. Bone Marrow Transplant 1994; 13: 277 - 283.
21. Ormrod D, Goa K. Valaciclovir: a review of its use in the manage- ment of herpes zoster. Drugs 2000; 59: 1317 - 1340.
22. Tuan IZ, Dennison D, Weisdorf DJ. Pneumocystis carini pneu- monitis following bone marrow transplantation. Bone Marrow Transplant 1992; 10: 267 - 272.
23. Hoyle C, Goldman JM. Life threatining infections occurring more than 3 months after BMT. Bone Marrow Transplant 1994; 14: 247 252.
24. Boeckh M, Leisenring W, Riddell SR, Bowden RA, Huang ML, Myerson D, Stevens-Avers T, Flowers ME, Cunningham T, Corey L. Late cytomegalovirus disease and mortality in recipients of al- logeneic hematopoietic stem cell transplants: importance of viral load and T cell immunity. Blood 2003; 101: 407 - 414.
25. Hale GA, Heslop HE, Krance RA, Brenner MA, Jayawardene D, Srivastava DK, Patrick CC. Adenovirus infection after pediatric bone marrow transplantation. Bone Marrow Transplant 1999; 23: 282.
26. Zerr DM, Corey L, Kim HW, Huang ML, Nguy L, Boeckh M. Clinical outcomes of human herpes virus 6 reactivation after he- matopoietic stem cell transplantation. Clin Infect Dis 2005; 40: 940.
27. Budak-Alpdoğan T, Tangün Y, Kalayoğlu Beşışık S, Ratip S, Akan H, Başlar Z, Soysal T, Bayık LA, Koç H. The frequency of tuber- culosis in adult allogeneic stem cell transplant recipients in Turkey. Biol Blood Marrow Transplant 2000; 6: 370 - 374.
28. Cahill RA, Spitzer TR, Mazumder A. Marrow engraftment and clinical manifestations of capillary leak syndrome. Bone Marrow Transplant 1996; 18: 177 - 184.
29. Capizzi SA, Kumar S, Huneke NE, Gertz MA, Inwards DJ, Lit- zow MR, Lacy MO, Gastineau DA, Prakash UB, Tefferi A. Peri- engraftment respiratory distress syndrome during autologous hematopoetic stem cell transplantation. Bone Marrow Transplant ; 27: 1299 - 1303.
30. Keates-Baleeiro J, Moore P, Koyama T, Manes B, Calder C, Fran- qoul H. Incidence and outcome of idiopathic pneumonia syndro- me in pediatric stem cell transplant recipients. Bone Marrow Transplant 2006; 38: 285 – 289.
31. Kantrow SP, Hackman RC, Boeckh M, Myerson D, Crawford SW. Idiopathic pneumonia syndrome : changing spectrum of lung in- jury after marrow transplantation. Transplantation 1997; 63: 1079 1086.
32. Fukuda T, Hackman RC, Guthrie KA, Sandmaier BM, Beeckh M, Maris MB, Maloney DG, Deeg HJ, Martin PJ, Storb RF, Madtes DK. Risks and outcomes of idiopathic pneumonia syndrome af- ter nonmyeloablative and conventional conditioning regimens for allogeneic hematopoetic stem cell transplantation. Blood 2003; : 2777 - 2785.
33. Heggen J, West C, Olson E, Olson T, Teague G, Fortenberry J, Ye- ager AM. Diffuse alveoler hemorrhage in pediatric hematopoietic cell transplant patients. Pediatrics 2002; 109: 965 - 971.
34. Ben Abraham R, Paret G, Cohen R, Szold O, Cividalli G, Toren A, Nagler A. Diffuse alveolar hemorrhage allogeneic bone marrow transplantation in children. Chest 2003; 124: 660 - 664.
35. Nevo S, Swan V, Enger C, Wojno KJ, Bitton R, Shabooti M, Fuller AK, Jones RJ, Braine HG, Vogelsang GB. Acute bleeding after bone marrow transplantation incidence and effect on survival. A quantative analysis in 1,402 patients. Blood 1998; 91: 1469
36. Palmas A, Tefferi A, Myers JL, Scott JP, Swensen SJ, Chen MG, Gastineau DA, Gertz MA, Inwards DJ, Lacy MQ, Litzow MR. Late onset noninfectious pulmonary complications after alloge- neic bone marrow transplantation. Br J Haematol 1998;100:680
37. Dudek AZ, Mahaseth H, Defor TE, Weisdorf DJ. Bronchiolitis obliterans in chronic graft versus host disease: Analysis of risk factors and treatment outcomes. Biol Blood Marrow Transplant ; 9: 657 - 666. Afessa B, Litzow MR, Tefferi A. Bronchiolitis obliterans and ot- her late onset noninfectious PCs in hematopoetic stem cell trans- plantation. Bone Marrow Transplant 2001; 28: 425 - 434.
38. Epler GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med 2001; 161: 158 - 164.
39. Curtis RE, Travis LB, Rowlings PA, Socie G, Kingma DW, Banks PM, Jaffe ES, Sale GE, Horowitz MM, Witherspoon RP, Shriner DA, Weisdorf DJ, Kolb HJ, Sullivan KM, Sobocinski KA, Gale RP, Hoover RN, Fraumeni JF, Deeg HJ. Risk of lymphoproliferative disorders after bone marrow transplantation: a multi-institutional study. Blood 1999; 94: 2208 - 2216.
40. Presneill JJ, Nakata K, Inoue Y, Seymour JF. Pulmonary alveolar proteinosis. Clin Chest Med 2004; 25: 593 - 613.