autologous hematopoietic stem cell transplantation

Autologous Stem Cell Transplantation in Primary Refractory Hodgkin’s Lymphoma: Supposed Zugzwang or Zwischenzug?

BONE MARROW TRANSPLANTATION , , , ,

GD Petrova1, KN Melkova1, TZ Chernyavskaya1, NV Gorbunova1, BV Afanas’ev2, EA Demina1, VN Kostrykina1, VA Doronin1

1 N.N. Blokhin Russian Cancer Research Center, 24 Kashirskoye sh., Moscow, Russian Federation, 115478

2 R.M. Gorbacheva Scientific Research Institute of Pediatric Hematology and Transplantation; Academician I.P. Pavlov First St. Petersburg State Medical University, 12 Rentgena str., Saint Petersburg, Russian Federation, 197022

For correspondence: Galina Dmitrievna Petrova, graduate student, 24 Kashirskoye sh., Moscow, Russian Federation, 115478; Tel.: +7(499)324-13-59; e-mail: galina_petrova@bk.ru

For citation: Petrova GD, Melkova KN, Chernyavskaya TZ, et al. Autologous Stem Cell Transplantation in Primary Refractory Hodgkin’s Lymphoma: Supposed Zugzwang or Zwischenzug? Clinical oncohematology. 2015;8(3):321–30 (In Russ).

ABSTRACT

Background & Aims. The role of single and double autologous hematopoietic stem cell transplantations (autoSCT) in patients with primary refractory Hodgkin’s lymphoma (HL) has not been determined yet. The aim of the study is to present the results of a one-center prospective study evaluating the role of single and double autoSCT in patients with HL who have not achieved the complete remission (CR) after first line induction polychemotherapy (PCT).

Methods. 62 HL patients were enrolled in the study over the period from 2007 till 2014. High-dose chemotherapy (HDCT) with autoSCT was performed once in 53 patients, and twice in 10 patients.

Results. The study demonstrated an unfavorable prognostic impact of the large volume of previous chemotherapy on the overall survival (OS) rate after the autoSCT (p = 0.03). Results of the 1st autoSCT had an independent prognostic value for the OS rate (p = 0.004). The study identified the main indication for the 2nd autoSCT, namely, partial remission (PR) or stable disease (SD) achieved after the 1st autoSCT (when the 2nd HDCT with autoSCT should be preferred to the alternative treatment; p = 0.004). Progressive disease (PD) after the first autoSCT is a contraindication for the second one. Due to low efficacy and high toxicity, the 2nd autoSCT does not improve outcomes when compared to alternative approaches (p = 0.6). The importance of achieving CR at any stage of treatment which is associated with a long life span with no signs of disease and good quality of life has been demonstrated.

Conclusion. AutoSCT is an effective treatment option for patients without complete remission after the first line antitumor treatment. Carrying out 2nd autoSCT is advisable for patients who have reached the PR/SD after the first one. Patients with PD after the 1st autoSCT require an alternative treatment option.

Keywords: Hodgkin’s lymphoma, high-dose chemotherapy, autologous hematopoietic stem cell transplantation, primary resistance, double autoSCT.

Received: May 5, 2015

Accepted: June 2, 2015

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REFERENCES

  1. Kantarjian H, Pasquini R, Hamerschlak N, et al. Dasatinib or high-dose imatinib for chronic-phase chronic myeloid leukemia after failure of first-line imatinib: a randomized phase 2 trial. Blood. 2007;109(12):5143–50. doi: 10.1182/blood-2006-11-056028.
  2. Kantarjian H, Giles F, Bhalla K, et al. Nilotinib is effective in patients with chronic myeloid leukemia in chronic phase after imatinib resistance or intolerance: 24-month follow-up results. Blood. 2011;117(4):1141–5. doi: 10.1182/blood-2010-03-277152.
  3. Лазорко Н.С., Ломаиа Е.Г., Сбитякова Е.И., Зарицкий А.Ю. Нилотиниб и дазатиниб в первой линии терапии больных хроническим миелолейкозом в хронической фазе. Современная онкология. 2011;13(1):38–40.
    [Lazorko NS, Lomaia EG, Sbityakova EI, Zaritskii AYu. Nilotinib and dazatinib as first line therapy of patients in chronic phase of chronic myeloid leukemia. Sovremennaya onkologiya. 2011;13(1):38–40. (In Russ)]
  4. Ломаиа Е.Г., Романова Е.Г., Сбитякова Е.И., Зарицкий А.Ю. Эффективность и безопасность ингибиторов тирозинкиназ 2-го поколения (дазатиниб, нилотиниб) в терапии хронической фазы хронического миелолейкоза. Онкогематология. 2013;2:22–33.
    [Lomaia EG, Romanova EG, Sbityakova EI, Zaritskii AYu. Efficacy and safety of 2nd generation tyrosine kinase inhibitors (dasatinib, nilotinib) in teatment of chronic phase of chronic myeloid leukemia. Onkogematologiya. 2013;2:22–33. (In Russ)]
  5. Туркина А.Г., Хорошко Н.Д., Гусарова Г.А. и др. Российский опыт применения нилотиниба во второй линии терапии больных хроническим миелолейкозом с резистентностью или непереносимостью иматиниба: оценка безопасности и эффективности в исследовании ENACT (расширенный доступ к нилотинибу в клинических исследованиях). Вестник гематологии. 2010;1(2):92–3.
    [Turkina AG, Khoroshko ND, Gusarova GA, et al. Russian experience in use of nilotinib in second line therapy of patients with chronic myeloid leukemia and imatinib resistance or intolerance: evaluation of safety and efficacy in ENACT trial (Expanding Nilotinib Access in Clinical Trials). Vestnik gematologii. 2010;1(2):92–3. (In Russ)]
  6. http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm.
  7. Kantarjian H, Giles F, Gattermann N, et al. Nilotinib (formerly AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is effective in patients with Philadelphia chromosome-positive chronic myelogenous leukemia in chronic phase following imatinib resistance and intolerance. Blood. 2007;110(10):3540–6. doi: 10.1182/blood-2007-03-080689.
  8. Saglio G, Kim D, Issaragrisil S, et al. Nilotinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2010;362(24):2251–9. doi: 10.1517/14656566.2011.534780.
  9. Hochhaus A, Kantarjian H, Baccarani M, et al. Dasatinib induces notable hematologic and cytogenetic responses in chronic phase chronic myeloid leukemia after failure of imatinib therapy. Blood. 2007;109(6):2303–9. doi: 10.1182/blood-2006-09-047266.
  10. Kantarjian H, Shah N, Hochhaus A, et al. Dasatinib versus imatinib in newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med. 2010;362:2260–70. doi: 10.1056/nejmoa1002315.
  11. Shah R. Drug-induced hepatotoxicity: pharmacokinetic perspectives and strategies for risk reduction. Adv Drug React Toxicol Rev. 1999;18:181–233.
  12. Russmann S, Kullak-Ublick G, Grattagliano I. Current concepts of mechanisms in drug-induced hepatotoxicity. Curr Med Chem. 2009;16(23):3041–53.
  13. Teo YL, Ho HK, Chan A. Risk of tyrosine kinase inhibitors-induced hepatotoxicity in cancer patients: A meta-analysis. Cancer Treat Rev. 2013;39(2):199–206. doi: 10.1016/j.ctrv.2012.09.004.
  14. Saglio G, Pinilla-Ibarz J, Cortes J, et al. Intolerance to tyrosine kinase inhibitors in chronic myeloid leukemia. Blood. 2011;117(4):688−697. doi: 10.1002/cncr.25648.
  15. Rosti G, Castagnetti F, Gugliotta G, et al. Dasatinib and nilotinib in imatinib resistant Philadelphia-positive chronic myelogenous leukemia: a ‘head-to-head’ comparison. Leuk Lymphoma 2010;51(4):583–91. doi: 10.3109/10428191003637282.
  16. Shah R, Morganroth J, Shah D. Hepatotoxicity of Tyrosine Kinase Inhibitors: Clinical and Regulatory Perspectives. Drug Saf. 2013;36(7):491–503. doi: 10.1007/s40264-013-0048-4.
  17. Lammie A, Drobnjak M, Gerald W, et al. Expression of c-kit and kit ligand proteins in normal human tissues. J Histochem Cytochem. 1994;42(11):1417–25. doi: 10.1177/42.11.7523489.
  18. Grichnik J, Burch J, Burchette J, Shea C. The SCF/KIT pathway plays a critical role in the control of normal human melanocyte homeostasis. J Invest Dermatol. 1998;111(2):233–8.
  19. Kantarjian H, Pasquini R, Levy V, et al. Dasatinib or high-dose imatinib for chronic-phase chronic myeloid leukemia resistant to imatinib at a dose of 400 to 600 milligrams daily: two-year follow-up of a randomized phase 2 study (START-R). Cancer. 2009;115(18):4136–47. doi: 10.1002/cncr.24504.
  20. Irvine E, Williams C. Treatment-, Patient-, and Disease-Related Factors and the Emergence of Adverse Events with Tyrosine Kinase Inhibitors for the Treatment of Chronic Myeloid Leukemia. Pharmacotherapy. 2013;33(8):868–81. doi: 10.1002/phar.1266.
  21. Van Etten RA. Cycling, stressed-out and nervous: cellular functions of cAbl. Trends Cell Biol. 1999;9(5):179–86. doi: 10.1016/s0962-8924(99)01549-4.
  22. Wasle B, Edwardson J. The regulation of exocytosis in the pancreatic acinar cell. Cell Signal. 2002;14(3):191–7. doi: 10.1016/s0898-6568(01)00257-1.
  23. Mooren F, Hlouschek V, Finkes T, et al. Early changes in pancreatic acinar cell calcium signalling after pancreatic duct obstruction. J Biol Chem. 2003;278(11):9361–9. doi: 10.1074/jbc.m207454200.
  24. Fitter S, Vandyke K, Gronthos S, Zannettino AC. Suppression of PDGF-induced PI3 kinase activity by imatinib promotes adipogsis and adiponectin secretion. J Mol Endocrinol. 2012;48(3):229–40. doi: 10.1530/jme-12-0003.
  25. Racil Z, Razga F, Drapalova J, et al. Mechanism of impaired glucose metabolism during nilotinib therapy in patients with chronic myelogenous leukemia. Haematologica. 2013;98(10):e124–6. doi: 10.3324/haematol.2013.086355.
  26. le Coutre P, Giles F, Hochhaus A, et al. Analysis of glucose profiles in imatinib resistant or intolerant chronic myelogenous leukemia (CML) patients treated with nilotinib: lack of correlation between glucose levels and nilotinib efficacy. Blood. 2007;110: Abstract 4588.
  27. Breccia M, Alimena G. Pleural/pericardic effusions during dasatinib treatment: incidence, management and risk factors associated to their development. Exp Opin Drug Saf. 2010;9(5):713–21. doi: 10.1517/14740331003742935.
  28. de Lavallade H, Punnialingam S, Milojkovic D, et al. Pleural effusions in patients with chronic myeloid leukaemia treated with dasatinib may have an immune-mediated pathogenesis. Br J Haematol. 2008;141(5):745–7. doi: 10.1111/j.1365-2141.2008.07108.x.
  29. Porkka K, Khoury H, Paquette R, et al. Dasatinib 100 mg once daily minimizes the occurrence of pleural effusion in patients with chronic myeloid leukemia in chronic phase and efficacy is unaffected in patients who develop pleural effusion. Cancer. 2010;116(2):377–86. doi: 10.1002/cncr.24734.
  30. Shah N, Kantarjian H, Kim D, et al. Six-year (yr) follow-up of patients (pts) with imatinib-resistant or -intolerant chronic-phase chronic myeloid leukemia (CML-CP) receiving dasatinib. J Clin Oncol. 2012;30:6506.
  31. Hasinoff BB. The cardiotoxicity and myocyte damage caused by small molecule anticancer tyrosine kinase inhibitors is correlated with lack of target specificity. Toxicol Appl Pharmacol. 2010;244(2):190–5. doi: 10.1016/j.taap.2009.12.032.
  32. Albini A, Pennesi G, Donatelli F, et al. Cardiotoxicity of anticancer drugs: the need for cardio-oncology and cardio-oncological prevention. J Natl Cancer Inst. 2010;102(1):14–25. doi: 10.1093/jnci/djp440.
  33. Strevel E, Ing D, Siu L. Molecularly targeted oncology therapeutics and prolongation of the QT interval. J Clin Oncol. 2007;25(22):3362–71. doi: 10.1200/jco.2006.09.6925.
  34. Haverkamp W, Breithardt G, Camm A, et al. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a policy conference of the European Society of Cardiology. Eur Heart J. 2000;21(15):1216–31. doi: 10.1053/euhj.2000.2249.
  35. Priori S, Schwartz P, Napolitano C, et al. Risk stratification in the long-QT syndrome. N Engl J Med. 2003;348(19):1866–74. doi: 10.1056/nejmoa022147.
  36. Sauer A, Moss A, McNitt S, et al. Long QT syndrome in adults. J Am Coll Cardiol. 2007;49(3):329–37. doi: 10.1016/j.jacc.2006.08.057.
  37. Center for Drug Evaluation and Research: Nilotinib Pharmacology/Toxicology Review and Evaluation; 2007.
  38. Le Coutre P, Ottmann O, Giles F, et al. Nilotinib (formerly AMN107), a highly selective BCR-ABL tyrosine kinase inhibitor, is active in patients with imatinib-resistant or -intolerant accelerated-phase chronic myelogenous leukemia. Blood. 2008;111(4):1834–9. doi: 10.1182/blood-2007-04-083196.
  39. Kantarjian H, Giles F, Wunderle L, et al. Nilotinib in imatinib-resistant CML and Philadelphia chromosome-positive ALL. N Engl J Med. 2006;354(24):2542–51. doi: 10.1056/nejmoa055104.
  40. Kim T, Rea D, Schwarz M, et al. Peripheral artery occlusive disease in chronic phase chronic myeloid leukemia patients treated with nilotinib or imatinib. Leukemia. 2013;27(6):1316–21. doi: 10.1038/leu.2013.70.
  41. Larson R, Hochhaus A, Hughes T, et al. Nilotinib vs imatinib in patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase: ENESTnd 3-year follow-up. Leukemia. 2012;26(10):2197–203. doi: 10.1038/leu.2012.134.
  42. Aichberger K, Herndlhofer S, Schernthaner G, et al. Progressive peripheral arterial occlusive disease and other vascular events during nilotinib therapy in CML. Am J Hematol. 2011;86(7):533–9. doi: 10.1002/ajh.22037.
  43. Verma D, Verstovsek S, Kantarjian H, et al. Malignancies occurring during therapy with tyrosine kinase inhibitors (TKIs) for chronic myeloid leukemia (CML) and other hematologic malignancies. Blood. 2011;118(16):4353–8. doi: 10.1182/blood-2011-06-362889.
  44. Hoffmann V, Baccarani M, Hasford J. The EUTOS population-based registry: incidence and clinical characteristics of 2904 CML patients in 20 European Countries. Leukemia. 2015;29(6):1336–43. doi: 10.1038/leu.2015.73 [Epub 2015 Mar 18]

Pulmonary complications of high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with hematological malignancies

COMPLICATIONS OF ANTITUMOR TREATMENT , ,

V.O. Sarzhevskiy, V.Ya. Melnichenko, V.P. Tyurin

N.I. Pirogov National Medico-surgical Center, RF MH, Moscow, Russian Federation

ABSTRACT

This review presents the recent data on the pulmonary complications after high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with hematological malignancies. The detailed information on the diagnostic approaches, pathogenetic and clinical features, prevention and treatment of the early and late pulmonary toxicity is provided.

Keywords: high-dose chemotherapy, autologous hematopoietic stem cell transplantation, pulmonary complications.

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REFERENCES

  1. Prince D.S., Wingard J.R., Saral R. et al. Longitudinal changes in pulmonary function following bone marrow transplantation. Chest 1989; 96(2): 301–6.
  2. Arvidson J., Bratteby L.E., Carlson K. et al. Pulmonary function after autologous bone marrow transplantation in children. Bone Marrow Transplant. 1994; 14(1): 117–23.
  3. Ghalie R., Szidon J.P., Thompson L. et al. Evaluation of pulmonary complications after bone marrow transplantation: the role of pretransplant pulmonary function tests. Bone Marrow Transplant. 1992; 10(4): 359–65.
  4. Nenadov Beck M., Meresse V., Hartmann O. et al. Long-term pulmonary sequelae after autologous bone marrow transplantation in children without total body irradiation. Bone Marrow Transplant. 1995; 16(6): 771–5.
  5. Badier M., Guillot C., Delpierre S. et al. Pulmonary function changes 100 days and one year after bone marrow transplantation. Bone Marrow Transplant. 1993; 12(5): 457–61.
  6. Ho V.T., Weller E., Lee S.J. et al. Prognostic factors for early severe pulmonary complications after hematopoietic stem cell transplantation. Biol. Blood Marrow Transplant. 2001; 7(4): 223–9.
  7. Shannon V.R., Andersson B.S., Lei X. et al. Utility of early versus late fiberoptic bronchoscopy in the evaluation of new pulmonary infiltrates following hematopoietic stem cell transplantation. Bone Marrow Transplant. 2010; 45(4): 647–55.
  8. Hofmeister C.C., Czerlanis C., Forsythe S. et al. Retrospective utility of bronchoscopy after hematopoietic stem cell transplantation. Bone Marrow Transplant. 2006; 38(10): 693–8.
  9. Azoulay E., Mokart D., Rabbat A. et al. Diagnostic bronchoscopy in hematology and oncology patients with acute respiratory failure: prospective multicenter data. Crit. Care Med. 2008; 36(1): 100–7.
  10. NCCN Guidelines Version 1.2012. Prevention and Treatment of CancerRelated Infection. 2012: 15.
  11. Sharma S., Nadrous H.F., Peters S.G. et al. Pulmonary complications in adult blood and marrow transplant recipients: autopsy findings. Chest. 2005; 128(3): 1385–92.
  12. Roychowdhury M., Pambuccian S.E., Aslan D.L. et al. Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center. Arch. Pathol. Lab. Med. 2005; 129(3): 366–71.
  13. Munker R., Lazarus H.M., Atkinson K. The BMT Data Book, 2nd edn. Cambridge University Press, 2009: 237.
  14. Frankovich J., Donaldson S.S., Lee Y. et al. High-dose therapy and autologous hematopoietic cell transplantation in children with primary refractory and relapsed Hodgkin’s disease: atopy predicts idiopathic diffuse lung injury syndromes. Biol. Blood Marrow Transplant. 2001; 7(1): 49–57.
  15. Avivi I., Hardak E., Shaham B. et al. Low incidence of long-term respiratory impairment in Hodgkin lymphoma survivors. Ann. Hematol. 2012; 91(2): 215–21.
  16. Arimura K., Inoue H., Kukita T. et al. Acute lung Injury in a healthy donor during mobilization of peripheral blood stem cells using granulocyte-colony stimulating factor alone. Haematologica 2005; 90(3): ECR10.
  17. Krishnan G.S., Chaudhary V., Al-Janadi A. et al. BCNU toxicity presenting with a large pericardial and pleural effusion. Ann. Transplant. 2008; 13(1): 44–7.
  18. Jones R.B., Matthes S., Shpall E.J. et al. Acute lung injury following treatment with high-dose cyclophosphamide, cisplatin, and carmustine: pharmacodynamic evaluation of carmustine. J. Natl. Cancer Inst. 1993; 85(8): 640–7.
  19. Puig N., de la Rubia J., Remigia M.J. et al. Morbidity and transplantrelated mortality of CBV and BEAM preparative regimens for patients with lymphoid malignancies undergoing autologous stem-cell transplantation. Leuk. Lymphoma 2006; 47(8): 1488–94.
  20. Stuart M.J., Chao N.S., Horning S.J. et al. Efficacy and toxicity of a CCNU-containing high-dose chemotherapy regimen followed by autologous hematopoietic cell transplantation in relapsed or refractory Hodgkin’s disease. Biol. Blood Marrow Transplant. 2001; 7(10): 552–60.
  21. Munker R., Hilderbrandt G.C., Lazarus H.M., Atkinson K. The BMT Data Book: including cellular therapy, 3nd edn. Cambridge University Press, 2013: 282.
  22. Malik S.W., Myers J.L., DeRemee R.A. et al. Lung toxicity associated with cyclophosphamide use. Two distinct patterns. Am. J. Respir. Crit. Care Med. 1996; 154(6 Pt. 1): 1851–6.
  23. Chen C.I., Abraham R., Tsang R. et al. Radiation-associated pneumonitis following autologous stem cell transplantation: predictive factors, disease characteristics and treatment outcomes. Bone Marrow Transplant. 2001; 27(2): 177–82.
  24. Afessa B., Abdulai R.M., Kremers W.K. et al. Risk factors and outcome of pulmonary complications after autologous hematopoietic stem cell transplant. Chest 2012; 141(2): 442–50.
  25. Halaburda K., Nasilowska-Adamska B., Grabarczyk P. et al. Limited predictive value of real-time quantitative PCR cytomegalovirus monitoring in the blood. Fatal CMV pneumonia in an autologous stem cell transplant recipient previously treated with alemtuzumab. Ann. Transplant. 2007; 12(2): 37–40.
  26. Mariotte E., Schnell D., Scieux C. et al. Significance of herpes-virus 6 in BAL fluid of hematology patients with acute respiratory failure. Infection 2011; 39(3): 225–30.
  27. Robbins R.A., Linder J., Stahl M.G. et al. Diffuse alveolar hemorrhage in autologous bone marrow transplant recipients. Am. J. Med. 1989; 87(5): 511–8.
  28. Afessa B., Tefferi A., Litzow M.R. et al. Diffuse alveolar hemorrhage in hematopoietic stem cell transplant recipients. Am. J. Respir. Crit. Care Med. 2002; 166(5): 641–5.
  29. Metcalf J.P., Rennard S.I., Reed E.C. et al. Corticosteroids as adjunctive therapy for diffuse alveolar hemorrhage associated with bone marrow transplantation. University of Nebraska Medical Center Bone Marrow Transplant Group. Am. J. Med. 1994; 96(4): 327–34.
  30. Lee C.K., Gingrich R.D., Hohl R.J. et al. Engraftment syndrome in autologous bone marrow and peripheral stem cell transplantation. Bone Marrow Transplant. 1995; 16(1): 175–82.
  31. Spitzer T.R. Engraftment syndrome following hematopoietic stem cell transplantation. Bone Marrow Transplant. 2001; 27(9): 893–8.
  32. Edenfield W.J., Moores L.K., Goodwin G. et al. An engraftment syndrome in autologous stem cell transplantation related to mononuclear cell dose. Bone Marrow Transplant. 2000; 25(4): 405–9.
  33. Nurnberger W., Willers R., Burdach S. et al. Risk factors for capillary leakage syndrome after bone marrow transplantation. Ann. Hematol. 1997; 74(5): 221–4.
  34. Kantrow S.P., Hackman R.C., Boeckh M. et al. Idiopathic pneumonia syndrome: changing spectrum of lung injury after marrow transplantation. Transplantation 1997; 63(8): 1079–86.
  35. Clark J.G., Hansen J.A., Hertz M.I. et al. NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am. Rev. Respir. Dis. 1993; 147(6 Pt. 1): 1601–6.
  36. Kato H., Yamamoto K., Taji H. et al. Interstitial pneumonia after autologous hematopoietic stem cell transplantation in B-cell non-Hodgkin lymphoma. Clin. Lymph. Myel. Leuk. 2011; 11(6): 483–9.
  37. Metzner B., Gruneisl R., Gebauer W. et al. Late infectious complications after high-dose therapy and autologous blood stem cell transplantation. Med. Klin. (Munich) 2002; 97(11): 650–8.
  38. Roy V., Weisdorf D. Mycobacterial infections following bone marrow transplantation: a 20 year retrospective review. Bone Marrow Transplant. 1997; 19(5): 467–70.
  39. Akan H., Arslan O., Akan O.A. et al. Tuberculosis in stem cell transplant patients. J. Hosp. Infect. 2006; 62(4): 421–6.
  40. Marras T.K., Chan C.K. Obliterative bronchiolitis complicating bone marrow transplantation. Semin. Respir. Crit. Care Med. 2003; 24(5): 531–42.
  41. Paz H.L., Crilley P., Patchefsky A., Schiffman R.L., Brodsky I. Bronchiolitis obliterans after autologous bone marrow transplantation. Chest 1992; 101(3): 775–8.
  42. Gulbahce H.E., Pambuccian S.E., Jessurun J. et al. Pulmonary nodular lesions in bone marrow transplant recipients: impact of histologic diagnosis on patient management and prognosis. Am J. Clin. Pathol. 2004; 121(2): 205–10.
  43. Witherspoon R.P., Fisher L.D., Schoch G. et al. Secondary cancers after bone marrow transplantation for leukemia or aplastic anemia. N. Engl. J. Med. 1989; 321(12): 784–9.
  44. Danner-Koptik K.E., Majhail N.S., Brazauskas R. et al. Second malignancies after autologous hematopoietic cell transplantation in children. Bone Marrow Transplant. 2013; 48(3): 363–8.