Supportive care in bone marrow transplantation: pulmonary complications

  • Stephen W. Crawford
Part of the Cancer Treatment and Research book series (CTAR, volume 77)


Overall, 40% to 60% of patients develop pulmonary disease at some time after marrow transplantation, and 24% to 40% require intensive care [1,2]. Characteristics such as increased HLA disparity with the donor source, high-dose conditioning regimens, active malignancy, and advanced age of the patient are associated with increased incidence of complications [3,4]. The incidence among patients who receive total body irradiation (TBI) for conditioning is higher than that of patients who receive only chemotherapy. Pneumonia as a clinical syndrome is the leading infectious cause of death, and until recently, Cytomegalovirus (CMV) was the most common cause of fatal pulmonary infection [5]. The incidence of some pulmonary infections, such as Pneumocystis carinii and perhaps bacterial pneumonia, has decreased due to the routine use of prophylactic antimicrobial agents. However, diffuse ‘idiopathic’ pulmonary injury continues, with mortality rate exceeding 60%. Newer understanding of idiopathic lung injury has led to the delineation of the recently coined ‘idiopathic pneumonia syndrome’ [6].


Bone Marrow Transplantation Chronic GVHD Airflow Obstruction Total Lung Capacity Allogeneic Bone Marrow Transplantation 
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© Springer Science+Business Media New York 1997

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  • Stephen W. Crawford

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