Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

Pediatr Radiol. 2008 Nov;38(11):1201-9. doi: 10.1007/s00247-008-0984-9. Epub 2008 Sep 4.


Background: Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established.

Objective: To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD).

Materials and methods: A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD.

Results: Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P = 0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT.

Conclusion: The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation*
  • Child
  • Child, Preschool
  • Female
  • Graft vs Host Disease / diagnostic imaging*
  • Humans
  • Infant
  • Longitudinal Studies
  • Lung Diseases / diagnostic imaging*
  • Male
  • Postoperative Complications / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*
  • Transplantation, Autologous
  • Transplantation, Homologous