Respiratory Symptoms Occurring 4 Months After Allogeneic Hematopoietic Stem Cell Transplantation

Bronchiolitis obliterans (BO) is the most frequent late-onset noninfectious pulmonary complication following an allogeneic hematologic stem cell transplantation attributed to chronic lung graft-versus-host disease. Its management is usually a great challenge when considering both the diagnosis and the treatment. The definite diagnosis relies on histological examination; however, lung biopsies are rarely available. The diagnosis must then be retained for converging arguments based on clinical and radiological features and pulmonary function testing. However, clinical, radiological and functional characteristics of patients with BO may be various, leading to difficulties in diagnosis. Furthermore, the treatment of BO is currently a controversial issue, and its evaluation is limited by not knowing the natural history. Herein, through a demonstrative case study, we discuss the diagnostic and therapeutic approach for a patient with a biopsy-proven BO following allogeneic stem cell transplantation.