[HTML][HTML] Alveolar levels of immuno-inflammatory mediators in diffuse alveolar hemorrhage after allogeneic transplant

LK Vande Vusse, MM Wurfel, DM Madtes… - Bone marrow …, 2018 - nature.com
LK Vande Vusse, MM Wurfel, DM Madtes, HG Schoch, S Harju-Baker, JA Hill, KR Jerome
Bone marrow transplantation, 2018nature.com
Idiopathic pneumonia syndrome (IPS) is a severe and morbid complication of hematopoietic
cell transplantation (HCT) that largely lacks effective treatments. The syndrome is defined as
abnormal pulmonary physiology with multilobar opacities on chest imaging that are not
attributable to lower respiratory tract infection (LRTI) or other organ failures [1]. Many
pathologies meet IPS criteria, including organizing pneumonia, interstitial pneumonitis, and
diffuse alveolar damage, among others. Biologic heterogeneity within this broadly defined …
Idiopathic pneumonia syndrome (IPS) is a severe and morbid complication of hematopoietic cell transplantation (HCT) that largely lacks effective treatments. The syndrome is defined as abnormal pulmonary physiology with multilobar opacities on chest imaging that are not attributable to lower respiratory tract infection (LRTI) or other organ failures [1]. Many pathologies meet IPS criteria, including organizing pneumonia, interstitial pneumonitis, and diffuse alveolar damage, among others. Biologic heterogeneity within this broadly defined syndrome may diminish the ability to detect the effect of treatments. An improved understanding of IPS pathobiology may catalyze the development of effective preventive and therapeutic strategies [2].
Several pro-inflammatory cytokines/chemokines are elevated in IPS [3, 4]. These biomarkers may be useful to distinguish IPS subphenotypes with unique biologic features. As a preliminary examination of this concept, we tested the hypothesis that immuno-inflammatory mediators measured in the blood and alveolar compartments of people with IPS differ according to the presence or absence of diffuse alveolar hemorrhage (DAH). DAH is a variably present manifestation of IPS that is proposed to have distinct biology [5]. We retrospectively studied 17 adults who underwent clinical bronchoscopy for diffusely abnormal chest imaging within 120 days of allogeneic HCT at Fred Hutchinson Cancer Research Center (FHCRC) between
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