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Chest
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Connective Tissue Disorders, Immunological Diseases, and Vasculitis
Thoracic Complications in Immunocompromised Patients
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cell Transplantation
Sonia L. Betancourt-Cuellar, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Hematopoietic stem cell transplantation (HSCT)

            • Definitions

              • HSCT
                • Types
                  • Bone marrow transplantation, peripheral blood stem cell transplantation, cord blood stem cell transplantation
                  • Autologous transplantation uses patient's own stem cells
                  • Allogeneic transplantation uses cells from human leukocyte antigen-consistent donor
                • Procedure
                  • High-dose chemotherapy &/or total body irradiation (TBI) followed by infusion of donor hematopoietic stem cells
                • Complications
                  • Infectious and noninfectious
                    • Noninfectious: Graft-vs.-host disease (GVHD); donor T-lymphocytes attack recipient's organs as foreign bodies, occurs with allogeneic transplantation

            IMAGING

            • General Features

              • Early Phase: Neutropenic (Pre-Engraftment) 0-30 Days

                • Early Phase: Early Posttransplant (30-100 Days)

                  • Late Phase (> 100 Days)

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Microscopic Features

                          CLINICAL ISSUES

                          • Demographics

                            • Graft-vs.-Host Disease

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                Selected References

                                1. Haider S et al: Noninfectious pulmonary complications of haematopoietic stem cell transplantation. Eur Respir Rev. 29(156), 2020
                                2. Boghanim T et al: Thoracic air-leak syndrome complicating allogeneic hematopoietic stem-cell transplantation. Lung. 197(1):101-3, 2019
                                3. Bondeelle L et al: Managing pulmonary complications in allogeneic hematopoietic stem cell transplantation. Expert Rev Respir Med. 13(1):105-19, 2019
                                4. Shroff GS et al: Imaging of pneumonias and other thoracic complications after hematopoietic stem cell transplantation. Curr Probl Diagn Radiol. 48(4):393-401, 2019
                                5. Bergeron A: Late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation. Clin Chest Med. 38(2):249-62, 2017
                                6. Tanaka N et al: High-resolution computed tomography of chest complications in patients treated with hematopoietic stem cell transplantation. Jpn J Radiol. 29(4):229-35, 2011
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        • Diagnostic Checklist

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Hematopoietic stem cell transplantation (HSCT)

                                          • Definitions

                                            • HSCT
                                              • Types
                                                • Bone marrow transplantation, peripheral blood stem cell transplantation, cord blood stem cell transplantation
                                                • Autologous transplantation uses patient's own stem cells
                                                • Allogeneic transplantation uses cells from human leukocyte antigen-consistent donor
                                              • Procedure
                                                • High-dose chemotherapy &/or total body irradiation (TBI) followed by infusion of donor hematopoietic stem cells
                                              • Complications
                                                • Infectious and noninfectious
                                                  • Noninfectious: Graft-vs.-host disease (GVHD); donor T-lymphocytes attack recipient's organs as foreign bodies, occurs with allogeneic transplantation

                                          IMAGING

                                          • General Features

                                            • Early Phase: Neutropenic (Pre-Engraftment) 0-30 Days

                                              • Early Phase: Early Posttransplant (30-100 Days)

                                                • Late Phase (> 100 Days)

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Demographics

                                                          • Graft-vs.-Host Disease

                                                            DIAGNOSTIC CHECKLIST

                                                            • Consider

                                                              Selected References

                                                              1. Haider S et al: Noninfectious pulmonary complications of haematopoietic stem cell transplantation. Eur Respir Rev. 29(156), 2020
                                                              2. Boghanim T et al: Thoracic air-leak syndrome complicating allogeneic hematopoietic stem-cell transplantation. Lung. 197(1):101-3, 2019
                                                              3. Bondeelle L et al: Managing pulmonary complications in allogeneic hematopoietic stem cell transplantation. Expert Rev Respir Med. 13(1):105-19, 2019
                                                              4. Shroff GS et al: Imaging of pneumonias and other thoracic complications after hematopoietic stem cell transplantation. Curr Probl Diagn Radiol. 48(4):393-401, 2019
                                                              5. Bergeron A: Late-onset noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation. Clin Chest Med. 38(2):249-62, 2017
                                                              6. Tanaka N et al: High-resolution computed tomography of chest complications in patients treated with hematopoietic stem cell transplantation. Jpn J Radiol. 29(4):229-35, 2011