Identification of Causes of 'Pulmonary Complications' After Hematopoietic Stem Cell Transplantation in Pediatric Leukemia

Seoul St. Mary's Hospital Professors Lee Hye-jin and Jo Bin
Low Lung Function Before Transplant
Combined High-Dose Chemotherapy
Increased Risk of Complications Such as Pneumonia

[Asia Economy Reporter Lee Gwan-joo] Domestic researchers have identified the causes of 'pulmonary complications' that occur after hematopoietic stem cell transplantation for treating pediatric leukemia.

The pediatric and adolescent medicine team led by Professors Lee Hye-jin and Jo Bin at the Catholic University Seoul St. Mary's Hospital announced on the 29th that their study, published in an international academic journal, found that pediatric patients who received high-dose chemotherapy before hematopoietic stem cell transplantation or who had reduced lung function had a higher risk of developing pulmonary complications after transplantation.

One treatment method for blood cancers such as pediatric leukemia is allogeneic hematopoietic stem cell transplantation, which involves receiving healthy hematopoietic stem cells. However, even if the transplantation is successful, pulmonary complications such as pneumonia can occur afterward. These complications significantly affect survival rates, but their causes vary depending on the type of blood cancer, transplantation method, graft-versus-host disease, infections, and other factors, making prediction and treatment difficult.

The research team investigated the effects of the types of chemotherapy administered during the transplantation process and pre-transplant lung function on the risk of pulmonary complications after transplantation in 617 pediatric and adolescent patients who underwent allogeneic hematopoietic stem cell transplantation at Seoul St. Mary's Hospital.

As a result, patients who received a high-dose combination of Busulfan and Fludarabine, chemotherapy agents administered to eliminate cancer cells before transplantation, had a 1.99 times higher risk of developing non-infectious pulmonary complications after transplantation. Additionally, patients with smaller lung alveolar volumes before transplantation had a 2.88 times higher risk of infectious pulmonary complications and a 4.28 times higher risk of non-infectious pulmonary complications after transplantation.

Professor Lee said, "Pulmonary complications occurring after pediatric hematopoietic stem cell transplantation are important diseases that can show poor prognosis even in patients cured of blood cancer. We hope this research will help predict patients at high risk of pulmonary complications and facilitate early treatment."

The study results were published in the November issue of the international academic journal Transplantation and Cellular Therapy, published by the American Society for Transplantation and Cellular Therapy (ASTCT). Prior to publication, the research received the Best Research Poster Award from the international academic organization CIPP, composed of pediatric respiratory specialists from over 70 countries.