Bronchiolitis obliterans organizing pneumonia (BOOP) with suspected liver graft-versus-host disease after allogeneic bone marrow transplantation

We report on a patient with chronic myelogenous leukemia who developed bron chiolitis obliterans organizing pneumonia (BOOP) after allogeneic bone marr ow transplantation (BMT). A 19-year-old Japanese male complained of dry cou gh and dyspnea 7 months after BMT. The chest X-ray and computed tomography revealed patchy infiltrates bilaterally. Lung function test, lung biopsy an d bronchoalveolar lavage were consistent with the diagnosis of BOOP. The pa tient also suffered from suspected graft-versus-host disease (GVHD) of the liver, after discontinuation of cyclosporine. Furthermore, prednisolone pro ved effective against the BOOP and the liver dysfunction. These findings in dicate that BOOP is a possible pulmonary manifestation of chronic GVHD, and that immunological mechanisms may have effected the onset of BOOP after BM T in this case.