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Pulmonary complications after allogeneic hematopoietic cell transplantation

Authors
Robert J Kaner, MD
Dana Zappetti, MD
Section Editors
Talmadge E King, Jr, MD
Robert S Negrin, MD
Deputy Editor
Helen Hollingsworth, MD

INTRODUCTION

Allogeneic hematopoietic cell transplantation (HCT) is the treatment of choice for many hematologic disorders. Pulmonary complications are a common cause of morbidity and occasionally mortality following this procedure [1-4].

Certain aspects of the transplant procedure influence the later development of pulmonary disease; the pretransplant conditioning regimen and posttransplant immunosuppression contribute to direct lung toxicity and increase the risk of opportunistic infections.

The pulmonary complications of allogeneic HCT will be reviewed here. The determination of eligibility for HCT, infectious complications of HCT, supportive care following HCT, and pulmonary complications of autologous HCT are discussed separately. (See "Determining eligibility for allogeneic hematopoietic cell transplantation" and "Overview of infections following hematopoietic cell transplantation" and "Management of the hematopoietic cell transplant recipient in the immediate post-transplant period" and "Pulmonary complications after autologous hematopoietic cell transplantation".)

OVERVIEW AND DEFINITIONS

Hematopoietic cell transplantation (HCT) is a general term for a variety of procedures in which the patient is treated with chemotherapy and/or irradiation (ie, the "preparative regimen") followed by the infusion of hematopoietic progenitor cells. Progenitor cells can come from a variety of sources (eg, bone marrow, peripheral blood, cord blood). (See "Sources of hematopoietic stem cells".)

Allogeneic versus autologous HCT — Allogeneic HCT refers to the use of hematopoietic progenitor cells collected from a relative (which can be human leukocyte antigen [HLA] identical, haploidentical, or mismatched) or an unrelated donor (volunteer or umbilical cord donor). Autologous HCT refers to collection of hematopoietic progenitor cells from the patient prior to the administration of high dose chemotherapy designed to target an underlying malignancy, followed by reinfusion of these cells.

                                 

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Literature review current through: Nov 2016. | This topic last updated: Thu Jan 07 00:00:00 GMT 2016.
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