Table 2.
Clinical features of acute lung injury syndromes post stem cell transplantation.
| Characteristic | Idiopathic Pneumonia Syndrome | Diffuse Alveolar Hemorrhage | Peri-Engraftment Respiratory Distress Syndrome |
|---|---|---|---|
| Epidemiology | More common after allo-SCT | Equal incidence after Auto and allo-SCT | More common after auto-SCT |
| Median time of onset | 30–40 days after allo-SCT | 20–25 days after SCT | From 3 days before to 7 days after engraftment |
| Relation to engraftment | No relation | No relation | Occurs during the peri-engraftment phase |
| Clinical features | Rapid progression to respiratory failure | Progressively bloodier aliquots of bronchoalveolar lavage | Systemic manifestations such as fever, rash |
| Pathology | Diffuse alveolar damage | Diffuse alveolar damage | Diffuse alveolar damage |
| Pathogenetic drivers * | TNFα | Various cytokines | GM-CSF, G-CSF |
| Response to corticosteroids | Poor, some response after anti-TNF agents | Moderate response to high dose steroids | Excellent response |
| Prognosis | Favorable | Moderate to Poor | Very poor |
* TNFα, tumor necrosis factor α; GM-CSF, granulocyte monocyte colony stimulating factor; G-CSF, granulocyte colony stimulating factor.