Abstract:

Objective To investigate the clinical characteristics and treatment outcomes of patients with idiopathic pneumonia syndrome (IPS) after allogenetic hematopoietic stem cell transplantation (HSCT). Methods Clinical characteristics, manifestations of lung function and imaging, and treatment processes of 5 patients with IPS from 70 patients undergoing HSCT in the Department of Hematology of the General Hospital Affiliated to Shanghai Jiao Tong University from January 2013 to December 2014 were retrospectively analyzed. Results All patients with IPS had the clinical manifestations of cough, expectoration, and different degrees of acute and chronic graft versus host disease (GVHD). Some of them had the clinical manifestations of fever, chest tightness, and hypoxemia. Lung CT showed multiple patchy shadows scattered in the lung field featured by accompanying ground glass shadows. The manifestation of pulmonary function of three patients was obstruction based mixed ventilation dysfunction, while the manifestation of other two patients was diffuse ventilation dysfunction. Symptoms of all patients were remarkably alleviated after glucocorticoid therapy. Imaging results showed most lesions were significantly absorbed. Conclusion IPS has special manifestations of imaging and pulmonary function after allogeneic HSCT and the clinical manifestations of GVHD commonly accompanies. Early comprehensive treatment including administration of glucocorticoid can obtain a satisfactory therapeutic effect.

Key words: allogeneic hematopoietic stem cell transplantation, idiopathic pneumonia syndrome, pulmonary function, graft versus host disease, lung CT