TABLE I.
Clinical Characteristics of the BOS and Non-BOS Control Cohorts
| BOS, n = 89 | cGVHD, n = 89 | No cGVHD, n = 87 | |
|---|---|---|---|
| Age (y) | 46.1 (12.1) | 44.9 (13) | 42 (12.4)a |
| Male gender | 48 (54%) | 57 (64%) | 49 (56%) |
| White race | 80 (90%) | 85 (96%) | 85 (98%) |
| Active smoking at Tx | 4 (5%) | 5 (6%) | 5 (6%) |
| Pretransplant history of pulmonary diseasec | 20 (22%) | 10 (11%) | 3 (3%)a |
| Respiratory Illness prior to day 100d | 23 (26%) | 11 (13%)a | 9 (10%)a |
| CMV positive | 40 (45%) | 35 (39%) | 28 (33%) |
| Acute GVHDe | 40 (45%) | 34 (38%) | 27 (31%) |
| Pretransplant PFTs | |||
| Pretransplant FEV1% | 89.3 (17) | 101 (14.7)a | 100.2 (14.8)a |
| Pretransplant FVC% | 90.9 (16.8) | 97.9 (12.6)a | 99.4 (14)a |
| Pretransplant FEV1/FVC | 76.1 (8.8) | 79.8 (6.3)a | 79.1 (7)a |
| Pretransplant TLC% | 90.1 (16.8) | 94.0 (11.1) | 94.9 (12.6) |
| Pretransplant RV% | 93.0 (30.8) | 85.2 (24.6) | 87.3 (26.6) |
| Pretransplant RV/TLC% | 102.7 (24.9) | 91.2 (19.4)a | 90.8 (26.0)a |
| Pretransplant DLCO% | 84.4 (22.1) | 90.4 (17.8) | 88.4 (20.7) |
| High-risk diseasef | 64 (72%) | 61 (69%) | 45 (52%)a,b |
| Cell source | |||
| PBSC | 76 (85%) | 73 (82%) | 55 (63%)a,b |
| Bone marrow | 10 (11%) | 13 (15%) | 17 (20%) |
| Cord cells | 3 (3%) | 3 (3%) | 14 (16%)a,b |
| Conditioning regimen | |||
| Busulfan/cyclophosphamidee | 4 (5%) | 2 (2%) | 1 (1%) |
| Cyclophosphamide/TBIg | 37 (42%) | 48 (54%) | 55 (63%)a |
| Busulfan/fludarabineh | 45 (51%) | 34(38%) | 13(15%)a,b |
| Melphalan/fludarabine | 3 (3%) | 3 (3%) | 13 (15%)a,b |
| Other | 0 (0%) | 2 (2%) | 5 (6%)a |
| GVHD prophylaxis | |||
| ATG in conditioning | 6 (7%) | 5 (6%) | 30 (34%)a,b |
| Sirolimus post HSCT | 51 (57%) | 52 (58%) | 37 (43%)b |
| Donor | |||
| Age (y) | 35.3 (11.8) | 39.4 (12.7)a | 33.9 (18.0) |
| Female | 46 (52%) | 32 (36%)a | 28 (31%)a |
| Gender mismatch | 37 (42%) | 38 (43%) | 42 (48%) |
| Unrelated | 65 (73%) | 50 (66%)a | 37 (41%)a,b |
| Mismatched | 14 (16%) | 9 (10%) | 15 (17%) |
| CMV positive | 30 (34%) | 28 (32%) | 25 (29%) |
P <0.05 BOS vs cGVHD and no cGVHD controls
P <0.05 cGVHD vs no cGVHD controls.
Pretransplant history of pulmonary disease included the following diagnoses: asthma, chronic obstructive pulmonary disease, emphysema, chronic bronchitis, and bronchiectasis that were not active at the time of diagnosis.
Patients treated for viral or bacterial infection per treating physician prior to day 100.
Acute GVHD was graded by consensus grading criteria [38].
All diseases other than CML CP1, AML/ALL CR1, MDS RA/RS, or AA are considered high-risk in this analysis.
Myeloablative conditioning regimens: cytoxan + total body irradiation 1400 cGY; high dose busulfan cyclophosphamide.
Reduced intensity conditioning regimen: fludarabine + low-dose intravenous busulfan (3.2–6.4 mg/kg).