BRONCHIOLITIS OBLITERANS ORGANIZING PNEUMONIA (BOOP) IN CHILDREN AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATION

Three pediatric patients of a cohort of 24 who underwent allogeneic bo ne marrow transplantation (BMT) from matched unrelated or mismatched f amily member donors developed low grade fever and cough between 2 and 3 months after BMT in the absence of clinical GVHD. Imaging studies re vealed bilateral patchy opacities and open lung biopsies revealed the characteristic histological appearance of bronchiolitis obliterans org anizing pneumonia. All three patients were treated with steroids and i n two patients the syndrome resolved over 1-2 months; the third patien t developed progressive pulmonary failure and died 2 weeks after diagn osis. BOOP may be an under-recognized respiratory complication followi ng BMT from a matched unrelated donor or mismatched family member.