Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous
Disease area: Interstitial lung diseases

Abstract

BO with /without organizing pneumonia (OP) are complications following bone marrow transplantation (BMT). Currently, there is no clear evidence that immunosuppressive therapy(IST) is effective on the course of BO. Corticosteroids (CS) are effective in BOOP, but the doses of CS are usually high and associated with adverse effects.Azithromycin (AZI), may have a beneficial effect in BO through its anti-inflammatory effect.It also may reduce the total dose and duration of CS in patients with BOOP.The aim of the current study was to investigate the potential effect of AZI on pulmonary function tests (PFTs) in BO and BOOP complicating BMT. PFTs of 156 patients who underwent BMT were followed at our institution the last three year period.We added AZI (250 mgr orally three times per week for a mean of 14.3 weeks) to the current IST in seven BMT recipients (mean age 37 years) with established BO (3 patients) in an attempt to prevent further decline of FEV1 and biopsy-proven BOOP (4 patients) to avoid the side-effects of high-dose CS. The diagnosis of BO was based on the presence of respiratory symptoms and air-trapping on expiratory lung high-resolution CT, associated with irreversible airflow obstruction. Clinically significant improvements were achieved both in FVC, where the mean increase reported was 313.33ml (180–430ml) and 855ml (350-1500ml), which was an average improvement of 13 % and 19.75%, and in FEV1, where the mean increase noticed was 343.33 mL (200–530ml) and 533.3 mL (260–740ml) which was an average improvement of 15.3% and 20% in the patients with BO and BOOP respectively. In conclusion, IST and AZI might be an option to treat BO and BOOP in BMT recipients.

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F. S. Oymak, N. Tutar, L. G. Kaynar, H. Buyukoglan, M. Gulec, O. Kontas, R. Demir, I. Gulmez (Kayseri, Turkey). Azithromycin in bronchiolitis obliterans (BO) and BO organizing pneumonia complicating bone marrow transplantation. Eur Respir J 2008; 32: Suppl. 52, 1628

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