Lymphocytic bronchitis associated with graft-versus-host disease in recipients of bone-marrow transplants

N Engl J Med. 1978 Nov 9;299(19):1030-6. doi: 10.1056/NEJM197811092991902.


Graft-versus-host disease, a complication of allogeneic bone-marrow transplantation, involves primarily the skin, liver and intestines, but may also be associated with pneumonia. To determine the relation of graft-versus-host disease with pneumonia, we evaluated the autopsies of 59 allogeneic and two autologous recipients and 74 control patients with various pulmonary diseases, who had not received a bone-marrow transplant. Lymphocytic bronchitis, characterized by lymphocyte-associated necrosis of the bronchial mucosa and often the submucosal glands, was present in 12 of 20 patients with Grade 2 or greater graft-versus-host disease but in only three of 39 with Grade 0 to 1 disease (P less than 0.0005). Onset of respiratory disease correlated with the time of onset of graft-versus-host disease. Patients with lymphocytic bronchitis had a higher incidence of bronchopneumonia and acute bronchitis of the lower respiratory tract. Lymphocytic bronchitis did not occur in the controls and appears to be a component of graft-versus-host disease that leads to bronchopneumonia, probably through destruction of the mucociliary apparatus.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow Transplantation*
  • Bronchi / pathology
  • Bronchitis / diagnosis
  • Bronchitis / etiology*
  • Bronchitis / pathology
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Graft vs Host Reaction*
  • Humans
  • Lymphocytes / pathology*
  • Male
  • Middle Aged
  • Mucous Membrane / pathology
  • Necrosis
  • Pneumonia / etiology
  • Respiratory Syncytial Viruses
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Virus Diseases / diagnosis