SHM Converge Scientific Abstract ePoster Gallery-Risk Factors for Idiopathic Pneumonia Syndrome After Hematopoietic Stem Cell Transplantation

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This retrospective cohort study examined idiopathic pneumonia syndrome (IPS) after hematopoietic stem cell transplantation (HSCT) using the Taiwanese Bone Marrow Transplantation Registry from 2009 to 2019. IPS is a serious, noninfectious lung injury complication after HSCT with high mortality, so the study aimed to estimate its incidence, identify risk factors, and assess survival outcomes.<br /><br />Among 3,924 HSCT patients, 43 (1.1%) developed IPS. The incidence was lower after autologous HSCT than after allogeneic HSCT. In univariate analysis, factors associated with higher IPS risk included complete remission before HSCT, allogeneic transplantation, total body irradiation (TBI)-based conditioning, rabbit antithymocyte globulin (ATG), hyperacute upper gastrointestinal GVHD, acute skin GVHD, and acute lower GI GVHD. Autologous HSCT was associated with lower risk.<br /><br />Multivariate analysis identified two strongest independent risk factors for IPS: TBI-based conditioning and hyperacute upper GI GVHD. These remained significant after adjustment, suggesting they are key predictors of IPS development.<br /><br />IPS was also associated with worse survival. The median time to IPS diagnosis was 34 days after HSCT, and 25 of 43 patients with IPS (58.1%) died within two years. Two-year overall survival was 64% in patients without IPS versus 49% in those with IPS. Among patients who developed IPS, two-year survival was 58% after autologous HSCT and 46% after allogeneic HSCT, but this difference was not statistically significant.<br /><br />Overall, the study found that IPS is uncommon in this national cohort but strongly linked to increased mortality. TBI-based conditioning and hyperacute upper GI GVHD were the most important independent risk factors.

Asset Subtitle

Quynh-Lan Dao

Meta Tag

Author List Arun Muthiah, Augustus Chang, Chien-Chang Lee, Hsiu-Hao Chang, Michael A. Liu, Quynh-Lan Dao

Category Research

Concept Idiopathic Pneumonia Syndrome

Concept Stem Cell Transplantation

Concept Risk Factor

Concept Toe-Brachial Index

Concept Upper Gastrointestinal Graft-Versus-Host Disease

Distinguished Non-Finalist

Presenter Organization Warren Alpert Medical School of Brown University

Presenting Author Quynh-Lan Dao

Track Outcomes Research

Keywords

idiopathic pneumonia syndrome

hematopoietic stem cell transplantation

HSCT

Taiwanese Bone Marrow Transplantation Registry

incidence

risk factors

total body irradiation

hyperacute upper gastrointestinal GVHD

allogeneic transplantation

survival outcomes

Idiopathic Pneumonia Syndrome

Stem Cell Transplantation

Risk Factor

Toe-Brachial Index

Upper Gastrointestinal Graft-Versus-Host Disease