Characteristics of patients with IPS and controls
| Characteristics . | Controls (N = 21) . | Patients with IPS . | ||
|---|---|---|---|---|
| Total (N = 69) . | Without pathogen (N = 31)* . | With pathogen (N = 38) . | ||
| Sex | ||||
| Male | 12 (57) | 35 (51) | 15 (48) | 20 (52) |
| Female | 9 (43) | 34 (49) | 16 (52) | 18 (48) |
| Age at transplantation, y | ||||
| ≤20 | 0 (0) | 4 (6) | 1 (3) | 3 (8) |
| 21-60 | 21 (100) | 63 (91) | 29 (94) | 34 (89) |
| >60 | 0 (0) | 2 (3) | 1 (3) | 1 (3) |
| Transplant year | ||||
| 1988-1998 | 21 (100) | 32 (46) | 12 (39) | 20 (53) |
| 1999-2006 | 0 (0) | 37 (54) | 19 (61) | 18 (47) |
| Disease risk at transplantation† | ||||
| Standard | 7 (33) | 37 (54) | 18 (58) | 19 (50) |
| High | 14 (67) | 32 (46) | 13 (42) | 19 (50) |
| Cell source | ||||
| Bone marrow | 21 (100) | 51 (74) | 22 (71) | 29 (76) |
| Peripheral blood stem cell | 0 (0) | 18 (26) | 9 (29) | 9 (24) |
| Donor type | ||||
| Matched related | 12 (57) | 23 (33) | 10 (32) | 13 (34) |
| Mismatched related | 2 (10) | 5 (7) | 3 (10) | 2 (5) |
| Unrelated | 7 (33) | 41 (59) | 18 (58) | 23 (61) |
| Conditioning regimen‡ | ||||
| MA including high-dose TBI | 18 (86) | 47 (68) | 20 (65) | 27 (71) |
| MA without TBI | 3 (14) | 21 (30) | 10 (32) | 11 (29) |
| Reduced intensity | 0 (0) | 1 (2) | 1 (3) | 0 (0) |
| GVHD prophylaxis | ||||
| CNI + MTX | 14 (67) | 62 (90) | 27 (87) | 35 (92) |
| Others§ | 7 (33) | 7 (10) | 4 (13) | 3 (8) |
| CMV serostatus | ||||
| Negative | 5 (24) | 33 (48) | 19 (61) | 14 (37) |
| Positive | 16 (76) | 36 (52) | 12 (39) | 24 (63) |
| % FEV1/FVC before transplantation | ||||
| ≥70 | 18 (86) | 55 (80) | 23 (74) | 32 (84) |
| <70 | 1 (5) | 11 (16) | 8 (26) | 3 (8) |
| Missing | 2 (10) | 3 (4) | 0 (0) | 3 (8) |
| % TLC before transplantation | ||||
| ≥80 | 19 (90) | 57 (83) | 28 (90) | 29 (76) |
| <80 | 0 (0) | 7 (10) | 3 (10) | 4 (11) |
| Missing | 2 (10) | 5 (7) | 0 (0) | 5 (13) |
| Days between transplantation and bronchoscopy | ||||
| ≤30 | 0 (0) | 48 (70) | 9 (29) | 12 (32) |
| 31-120 | 21 (100) | 21 (30) | 22 (71) | 26 (68) |
| Days between transplantation and bronchoscopy, median (range)|| | 42 (40-46) | 22 (4-119) | 19 (4-99) | 22.5 (8-119) |
| Bacteremia/candidemia at bronchoscopy | ||||
| No | 20 (95) | 64 (93) | 28 (90) | 36 (95) |
| Yes | 1 (5) | 4 (6) | 2 (6) | 2 (5) |
| Missing | 0 (0) | 1 (1) | 1 (3) | 0 (0) |
| White blood cell counts at bronchoscopy | ||||
| >1.0 × 10 e9/L | 21 (100) | 36 (52) | 15 (48) | 21 (55) |
| ≤1.0 × 10 e9/L | 0 (0) | 33 (48) | 16 (52) | 17 (45) |
| Lymphocyte count at bronchoscopy | ||||
| >0.2 × 10 e9/L | 17 (81) | 31 (45) | 13 (42) | 18 (47) |
| ≤0.2 × 10 e9/L | 4 (19) | 37 (54) | 17 (55) | 20 (53) |
| Missing | 0 (0) | 1 (1) | 1 (3) | 0 (0) |
| Neutrophil count at bronchoscopy | ||||
| >0.5 × 10 e9/L | 21 (100) | 37 (54) | 14 (45) | 23 (61) |
| ≤0.5 × 10 e9/L | 0 (0) | 32 (46) | 17 (55) | 15 (39) |
| Acute GVHD at bronchoscopy | ||||
| Grade 0-1 | 7 (33) | 20 (29) | 14 (45) | 6 (16) |
| Grade 2-4 | 14 (67) | 49 (71) | 17 (55) | 32 (84) |
| Steroid dose before bronchoscopy¶ | ||||
| No | 9 (43) | 37 (54) | 20 (64) | 17 (45) |
| <2 mg/kg | 5 (24) | 12 (17) | 4 (13) | 8 (21) |
| ≥2 mg/kg | 6 (29) | 20 (29) | 7 (23) | 13 (34) |
| Missing | 1 (5) | 0 (0) | 0 (0) | 0 (0) |
| DAH | ||||
| No | 21 (100) | 46 (67) | 23 (74) | 23 (61) |
| Yes | 0 (0) | 23 (33) | 8 (26) | 15 (39) |
| Treatment after bronchoscopy# | ||||
| None/steroid <1 mg/kg | 11 (52) | 8 (12) | 5 (16) | 3 (8) |
| Steroid 1-2 mg/kg | 9 (43) | 22 (32) | 11 (34) | 11 (29) |
| Steroid >2 mg/kg | 1 (5) | 39 (56) | 15 (48) | 24 (63) |
| TNF-receptor inhibitor | 0 (0) | 3 (4) | 3 (10) | 0 (0) |
| Characteristics . | Controls (N = 21) . | Patients with IPS . | ||
|---|---|---|---|---|
| Total (N = 69) . | Without pathogen (N = 31)* . | With pathogen (N = 38) . | ||
| Sex | ||||
| Male | 12 (57) | 35 (51) | 15 (48) | 20 (52) |
| Female | 9 (43) | 34 (49) | 16 (52) | 18 (48) |
| Age at transplantation, y | ||||
| ≤20 | 0 (0) | 4 (6) | 1 (3) | 3 (8) |
| 21-60 | 21 (100) | 63 (91) | 29 (94) | 34 (89) |
| >60 | 0 (0) | 2 (3) | 1 (3) | 1 (3) |
| Transplant year | ||||
| 1988-1998 | 21 (100) | 32 (46) | 12 (39) | 20 (53) |
| 1999-2006 | 0 (0) | 37 (54) | 19 (61) | 18 (47) |
| Disease risk at transplantation† | ||||
| Standard | 7 (33) | 37 (54) | 18 (58) | 19 (50) |
| High | 14 (67) | 32 (46) | 13 (42) | 19 (50) |
| Cell source | ||||
| Bone marrow | 21 (100) | 51 (74) | 22 (71) | 29 (76) |
| Peripheral blood stem cell | 0 (0) | 18 (26) | 9 (29) | 9 (24) |
| Donor type | ||||
| Matched related | 12 (57) | 23 (33) | 10 (32) | 13 (34) |
| Mismatched related | 2 (10) | 5 (7) | 3 (10) | 2 (5) |
| Unrelated | 7 (33) | 41 (59) | 18 (58) | 23 (61) |
| Conditioning regimen‡ | ||||
| MA including high-dose TBI | 18 (86) | 47 (68) | 20 (65) | 27 (71) |
| MA without TBI | 3 (14) | 21 (30) | 10 (32) | 11 (29) |
| Reduced intensity | 0 (0) | 1 (2) | 1 (3) | 0 (0) |
| GVHD prophylaxis | ||||
| CNI + MTX | 14 (67) | 62 (90) | 27 (87) | 35 (92) |
| Others§ | 7 (33) | 7 (10) | 4 (13) | 3 (8) |
| CMV serostatus | ||||
| Negative | 5 (24) | 33 (48) | 19 (61) | 14 (37) |
| Positive | 16 (76) | 36 (52) | 12 (39) | 24 (63) |
| % FEV1/FVC before transplantation | ||||
| ≥70 | 18 (86) | 55 (80) | 23 (74) | 32 (84) |
| <70 | 1 (5) | 11 (16) | 8 (26) | 3 (8) |
| Missing | 2 (10) | 3 (4) | 0 (0) | 3 (8) |
| % TLC before transplantation | ||||
| ≥80 | 19 (90) | 57 (83) | 28 (90) | 29 (76) |
| <80 | 0 (0) | 7 (10) | 3 (10) | 4 (11) |
| Missing | 2 (10) | 5 (7) | 0 (0) | 5 (13) |
| Days between transplantation and bronchoscopy | ||||
| ≤30 | 0 (0) | 48 (70) | 9 (29) | 12 (32) |
| 31-120 | 21 (100) | 21 (30) | 22 (71) | 26 (68) |
| Days between transplantation and bronchoscopy, median (range)|| | 42 (40-46) | 22 (4-119) | 19 (4-99) | 22.5 (8-119) |
| Bacteremia/candidemia at bronchoscopy | ||||
| No | 20 (95) | 64 (93) | 28 (90) | 36 (95) |
| Yes | 1 (5) | 4 (6) | 2 (6) | 2 (5) |
| Missing | 0 (0) | 1 (1) | 1 (3) | 0 (0) |
| White blood cell counts at bronchoscopy | ||||
| >1.0 × 10 e9/L | 21 (100) | 36 (52) | 15 (48) | 21 (55) |
| ≤1.0 × 10 e9/L | 0 (0) | 33 (48) | 16 (52) | 17 (45) |
| Lymphocyte count at bronchoscopy | ||||
| >0.2 × 10 e9/L | 17 (81) | 31 (45) | 13 (42) | 18 (47) |
| ≤0.2 × 10 e9/L | 4 (19) | 37 (54) | 17 (55) | 20 (53) |
| Missing | 0 (0) | 1 (1) | 1 (3) | 0 (0) |
| Neutrophil count at bronchoscopy | ||||
| >0.5 × 10 e9/L | 21 (100) | 37 (54) | 14 (45) | 23 (61) |
| ≤0.5 × 10 e9/L | 0 (0) | 32 (46) | 17 (55) | 15 (39) |
| Acute GVHD at bronchoscopy | ||||
| Grade 0-1 | 7 (33) | 20 (29) | 14 (45) | 6 (16) |
| Grade 2-4 | 14 (67) | 49 (71) | 17 (55) | 32 (84) |
| Steroid dose before bronchoscopy¶ | ||||
| No | 9 (43) | 37 (54) | 20 (64) | 17 (45) |
| <2 mg/kg | 5 (24) | 12 (17) | 4 (13) | 8 (21) |
| ≥2 mg/kg | 6 (29) | 20 (29) | 7 (23) | 13 (34) |
| Missing | 1 (5) | 0 (0) | 0 (0) | 0 (0) |
| DAH | ||||
| No | 21 (100) | 46 (67) | 23 (74) | 23 (61) |
| Yes | 0 (0) | 23 (33) | 8 (26) | 15 (39) |
| Treatment after bronchoscopy# | ||||
| None/steroid <1 mg/kg | 11 (52) | 8 (12) | 5 (16) | 3 (8) |
| Steroid 1-2 mg/kg | 9 (43) | 22 (32) | 11 (34) | 11 (29) |
| Steroid >2 mg/kg | 1 (5) | 39 (56) | 15 (48) | 24 (63) |
| TNF-receptor inhibitor | 0 (0) | 3 (4) | 3 (10) | 0 (0) |
All values are indicated as the number (percentage).
CNI, calcineurin inhibitor; CSP, cyclosporine; FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; GVHD, graft-versus-host disease; MA, myeloablative; MMF, mycophenolate mofetil; MTX, methotorexate; TBI, total body irradiation; % TLC, percentage of predicted total lung capacity; TNF, tumor necrosis factor.
This includes a patient with ciHHV-6.
Disease risk group at transplantation was classified into 2 groups: standard and high as previously described.27
Myeloablative conditioning regimens mainly consisted of high-dose cyclophosphamide and busulfan with or without fractionated TBI (12.0 or 13.2 Gy). Reduced intensity conditioning regimen consisted of fludarabine with a single fraction of TBI (2 Gy).
Others include MTX alone, CSP alone, CSP + steroid, and CSP + MMF.
This variable indicates median (range).
Steroid dose before diagnosis of IPS was defined as peak dose from the period within 2 weeks before bronchoscopy.38
The treatment was started within 3 weeks after bronchoscopy. Steroid dose was defined as peak dose within 3 weeks after bronchoscopy. Three patients that received TNF-receptor inhibitor were also included in the group of steroid >2 mg/kg.