Birgitta Versluijs

17 Introduction 1 Aims and outline of this thesis Allo-immune mediated Lung Syndromes (Allo-LS) are important contributors to Treat- ment Related morbidity and mortality after Hematopoietic Cell Transplantation. The aim of this thesis is to: 1. better understand predictors for Allo-LS 2. improve diagnostic tools to distinguish primarily infectious pathology from immune mediated disease 3. elucidate on determinants influencing therapy response 4. evaluate the impact of Allo-LS on long term outcome More insight in underlying pathophysiology hopefully results in the identification of fu- ture targets for preventive and therapeutic strategies. Chapter 2 gives a general overview of pulmonary complications in childhood cancer sur- vivors. Chapter 3 shows the relation between the presence of community acquired Respi- ratory Viruses (RV) and severe Allo-LS in pediatric HCT recipients. Chapter 4 discusses the importance of chest HRCT in diagnosing Allo-LS. Chapter 5 unveils the yield of pre-HCT pulmonary screening in children. Chapter 6 focusses on Respiratory Syncytial Virus (RSV) infection in pediatric HCT-recipients. Chapter 7 further explores the risk of early RV infection in the lungs as being cause for Allo-LS in children after HCT. Chap- ter 8 describes an Allo-LS cohort and gives prognostic factors for therapy response and overall outcome. In chapter 9 the results outlined in this thesis are discussed, with focus on implications of our findings for clinical care, and future perspectives for (clinical) research. Chapter 10 provides a summary in Dutch of this thesis.