Clinical risk factors and prognostic model for patients with bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation

ABSTRACT Bronchiolitis obliterans syndrome (BOS) is a common and potentially devastating noninfectious pulmonary complication after allogeneic hematopoietic stem cell transplantation

(allo-HSCT). Currently, predictive tools for BOS are not available. We aimed to identify the clinical risk factors and establish a prognostic model for BOS in patients who undergo allo-HSCT.

We retrospectively identified a cohort comprising 195 BOS patients from 6100 consecutive patients who were allografted between 2008 and 2022. The entire cohort was divided into a derivation

cohort and a validation cohort based on the time of transplantation. Via multivariable Cox regression methods, declining forced expiratory volume at 1 s (FEV1) to <40%, pneumonia, cGVHD

except lung, and respiratory failure were found to be independent risk factors for the 3-year mortality of BOS. A risk score called FACT was constructed based on the regression coefficients.

The FACT model had an AUC of 0.863 (95% CI: 0.797–0.928) in internal validation and 0.749 (95% CI: 0.621–0.876) in external validation. The calibration curves showed good agreement between

the FACT-predicted probabilities and actual observations. The FACT risk score will help to identify patients at high risk and facilitate future research on developing novel, effective

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Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS LATE-ONSET PULMONARY COMPLICATIONS FOLLOWING ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION IN PEDIATRIC

PATIENTS: A PROSPECTIVE MULTICENTER STUDY Article 07 March 2024 EVALUATION OF RISK FOR BRONCHIOLITIS OBLITERANS SYNDROME AFTER ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION WITH

MYELOABLATIVE CONDITIONING REGIMENS Article Open access 27 September 2024 IMPACT OF LUNG FUNCTION IMPAIRMENT AFTER ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION Article Open access 19

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Development Program of China (No. 2021YFC2500304), Key Program of National Natural Science Foundation of China (No. 82230004), National Natural Science Foundation of China (No. 81970113),

Youth Program of National Natural Science Foundation of China (No. 82200136), and the Capital Health Research and Development of Special (No. 2022-1-4082). AUTHOR INFORMATION Author notes *

These authors contributed equally: Qiu-Sha Huang, Tian-Xiao Han. AUTHORS AND AFFILIATIONS * Peking University People’s Hospital, Peking University Institute of Hematology, Beijing, China

Qiu-Sha Huang, Tian-Xiao Han, Qi Chen, Jin Wu, Peng Zhao, Ye-Jun Wu, Yun He, Xiao-Lu Zhu, Hai-Xia Fu, Feng-Rong Wang, Yuan-Yuan Zhang, Xiao-Dong Mo, Wei Han, Chen-Hua Yan, Jing-Zhi Wang, 

Huan Chen, Yu-Hong Chen, Ting-Ting Han, Meng Lv, Yao Chen, Yu Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang & Xiao-Hui Zhang * National Clinical Research Center for Hematologic Disease,

Beijing, China Qiu-Sha Huang, Tian-Xiao Han, Qi Chen, Jin Wu, Peng Zhao, Ye-Jun Wu, Yun He, Xiao-Lu Zhu, Hai-Xia Fu, Feng-Rong Wang, Yuan-Yuan Zhang, Xiao-Dong Mo, Wei Han, Chen-Hua Yan, 

Jing-Zhi Wang, Huan Chen, Yu-Hong Chen, Ting-Ting Han, Meng Lv, Yao Chen, Yu Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang & Xiao-Hui Zhang * Beijing Key Laboratory of Hematopoietic

Stem Cell Transplantation, Beijing, China Qiu-Sha Huang, Tian-Xiao Han, Qi Chen, Jin Wu, Peng Zhao, Ye-Jun Wu, Yun He, Xiao-Lu Zhu, Hai-Xia Fu, Feng-Rong Wang, Yuan-Yuan Zhang, Xiao-Dong Mo,

 Wei Han, Chen-Hua Yan, Jing-Zhi Wang, Huan Chen, Yu-Hong Chen, Ting-Ting Han, Meng Lv, Yao Chen, Yu Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang & Xiao-Hui Zhang * Collaborative

Innovation Center of Hematology, Peking University, Beijing, China Qiu-Sha Huang, Tian-Xiao Han, Qi Chen, Jin Wu, Peng Zhao, Ye-Jun Wu, Yun He, Xiao-Lu Zhu, Hai-Xia Fu, Feng-Rong Wang, 

Yuan-Yuan Zhang, Xiao-Dong Mo, Wei Han, Chen-Hua Yan, Jing-Zhi Wang, Huan Chen, Yu-Hong Chen, Ting-Ting Han, Meng Lv, Yao Chen, Yu Wang, Lan-Ping Xu, Kai-Yan Liu, Xiao-Jun Huang & 

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this author inPubMed Google Scholar * Qi Chen View author publications You can also search for this author inPubMed Google Scholar * Jin Wu View author publications You can also search for

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for this author inPubMed Google Scholar CONTRIBUTIONS XHZ, QSH and TXH contributed to the concept and design. PZ, YJW, YH, XLZ, HXF, FRW, YYZ, XDM, WH, CHY, JZW, HC, YHC, TTH, ML, YC, QSH

and TXH collected the data. QSH and XHZ contributed to data interpretation and data analysis. XHZ, QSH and TXH performed statistical analysis. YW, LPX, KYL, XJH and XHZ revised it

critically. XHZ, QSH and TXH wrote the manuscript. XHZ designed, conceived and supervised the study, analyzed the data, and drafted and revised the manuscript. All authors critically

reviewed and approved the final version of the manuscript. CORRESPONDING AUTHOR Correspondence to Xiao-Hui Zhang. ETHICS DECLARATIONS COMPETING INTERESTS The authors declare no competing

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applicable law. Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Huang, QS., Han, TX., Chen, Q. _et al._ Clinical risk factors and prognostic model for patients with

bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation. _Bone Marrow Transplant_ 59, 239–246 (2024). https://doi.org/10.1038/s41409-023-02151-9 Download citation *

Received: 05 September 2023 * Revised: 26 October 2023 * Accepted: 07 November 2023 * Published: 27 November 2023 * Issue Date: February 2024 * DOI:

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