Birgitta Versluijs

Strong association between respiratory viral infec- tion early after hematopoietic stem cell transplan- tation and the development of life-threatening acute and chronic alloimmune lung syndromes A.B. Versluys, J.W.A. Rossen, B. van Ewijk, R. Schuurman, M.B. Bierings, J.J. Boelens Biol Blood MarrowTransplant 2010; 16: 782-791 Abstract Alloimmune lung syndromes (allo-LS), including idio- pathic pneumonia syndrome, bronchiolitis obliterans syndrome, and bronchiolitis obliterans organizing pneumonia, are severe complications after hemato- poietic stem cell transplantation (HSCT). In our co- hort of 110 pediatric patients, 30 had allo-LS (27.3%), 18 with ideopathic pneumonia syndrome and 12 with bronchiolitis obliterans syndrome. Multivariate analysis showed that respiratory viral infection early after HSCT is an important predictor for the development of allo-LS (P <.0001). This was true for all viruses tested. In multi- variate analysis, allo-LS was the only predictor for higher mortality (P = .04). Paradoxically, prolonged adminis- tration of immunosuppressive agents because of acute graft-versus-host disease had a protective effect on the development of allo-LS (P = .004). We hypothesize that early infection of the respiratory tract with a common cold virus makes the lungs a target for alloimmunity. Blood and MarrowTransplan- tation Program, Department of Pediatrics, University Me- dical Center Utrecht (UMCU), Utrecht, The Netherlands A.B. Versluys M.B. Bierings J.J. Boelens Department of Virology, Eijk- man-Winkler Center, UMCU, Utrecht, The Netherlands J.W.A. Rossen R. Schuurman Laboratory of Medical Micro- biology and Immunology, St Elisabeth Hospital, Tilburg, The Netherlands J.W. A. Rossen Department of Paediatric Respiratory Medicine, UMCU, Wilhelmina Children’s Hospital, Utrecht, The Netherlands B. van Ewijk