Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous

Abstract

Rationale: Bronchiolitis obliterans (BO) is a frequent and severe complication of hematopoietic stem cell transplantation (HSCT). Previous studies reported improvement in pulmonary function in lung transplant recipients with BO treated with azithromycin (AZI). A preliminary study showed encouraging results in HSCT recipients with BO.
Objectives: to assess the clinical and functional effects of AZI in allogeneic HSCT recipients with BO.
Methods: single-center retrospective study. Ten patients with BO receiving AZI 250mg daily were included. BO was defined by a 20% or more decline in forced expiratory volume in one second (FEV1) or in mid-expiratory flow at 25-75% of vital capacity (FEF 25-75).
Results: all patients had chronic Graft-vs-Host Disease, 9/10 requiring immunosuppressive therapies. AZI was initiated at a mean of 43±26 months after HSCT. Average FEV1 was 2009ml/min±359 (60%±11% of predicted values). Mean duration of treatment was 10 months, with 5/10 patients treated for 1 year or longer. No significant change in FEV1, FEF 25-75, 6minute-walking-distance occurred, except for one patient who experienced significant improvement in FEV1 (+680ml) alone. Cough and sputum decreased in 7/10 patients. No adverse effects related to AZI occurred.
Conclusion: long term azithromycin therapy did not improve lung function in HSCT recipients with BO but improved dramatically clinical symptoms. So further studies are required.

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F. Lemonnier, E. Catherinot, H. Neveu, L. J. Couderc, E. Rivaud (Suresnes, France). Long term azithromycin use for bronchiolitis obliterans in ten allogeneic hematopoietic stem cell transplant recipients. Eur Respir J 2008; 32: Suppl. 52, 1631

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