Non-infectious lung complications are closely associated with chronic graft-versus-host disease: a single center study of incidence, risk factors andoutcome

Non-infectious lung complications (NILC) are frequent, influencing morbidit y and mortality of patients after allogeneic BMT. Although the term NILC en compasses a number of different entities, an association with GVHD has been noted for almost all of them. Our study was directed towards assessing the incidence and risk factors for developing NILC, as well as the response to treatment and long-term outcome. Forty (14.7%) out of 272 patients survivi ng for more than 3 months after allogeneic BMT, developed lung complication s fulfilling the criteria for NILC. The evaluation was based on clinical in vestigation, radiologic imaging, lung function tests, broncho-alveolar lava ge and biopsies. Risk factors were assessed by univariate and multiple stat istical regression models, where chronic GVHD proved to be the only signifi cant risk factor for the development of NILC (P = 0.011). In three patients NILC developed in direct association with donor lymphocyte infusions. The majority of patients responded well to treatment with corticosteroids and i mmunosuppressive drugs, NILC had no adverse effect on survival. The frequen cy of NILC was low in autologous (5%) as compared with allogeneic transplan ts (14.7%) but this difference was not statistically significant.