Adult respiratory distress syndrome-like disorders after allogeneic bone marrow transplantation.

Background. Adult respiratory distress syndrome-like respiratory disorders are a serious, but uncommon, complication of bone marrow transplantation. Methods. We measured various cytokines in 2 patients with respiratory disor ders and 11 patients without respiratory problems after allogeneic bone mar row transplantation. Results. The patients with respiratory disorders had elevated levels of int erferon-gamma and interleukin-2 in the aplastic phase, and elevation of tum or necrosis factor-alpha intercellular adhesion molecule-1, and interleukin -8 at the time of leukocyte recovery. Both patients with respiratory disord ers developed fever during the aplastic phase, whereas none of the patients without fever had respiratory disorders. Among patients who had fever duri ng the aplastic phase but no respiratory disorders, there was no elevation of cytokines from the aplastic phase to the recovery phase. Conclusions. Respiratory disorders may occur after bone marrow transplantat ion when an inflammatory response during the aplastic phase stimulates cyto kines that cause vascular endothelial damage and increases the levels of ch emokines and adhesive molecules along with elevation of the leukocyte count .