Pulmonary complications of haematopoetic stem cell transplantation

There are many thoracic complications that can occur following hematopoietic stem cell transplantation. These can precipitate during various stages following transplantation and can be either infectious or noninfectious.

Complications

Early

• pulmonary edema
• engraftment syndrome
• diffuse alveolar hemorrhage
• drug-induced lung injury
• idiopathic pneumonia syndrome
• pneumonias (especially during neutropenic phase)
  • bacterial pneumonia (in up to 10%)
    • septic emboli from central venous catheters 
  • cytomegalovirus pneumonia 
  • Pneumocystis jirovecii pneumonia
  • pulmonary aspergillus infection
• acute graft versus host disease
• pleural effusion +/- pericardial effusion
• pulmonary veno-occlusive disease

Late

• chronic graft versus host disease
  • bronchiolitis obliterans
    • thoracic air leak syndrome
      • spontaneous pneumothoraces (rare) 
  • cryptogenic organizing pneumonia
  • other interstitial pneumonias
    • lymphocytic interstitial pneumonia 
• post-transplant lymphoproliferative disorder

See also

• thoracic manifestations of graft versus host disease