A Systematic Review on Pulmonary Complications Secondary to Hematopoietic Stem Cell Transplantation

The main purpose of this systematic review was to identify and synthesize evidence about pulmonary complications following stem cell transplantation, to raise awareness among physicians since it is a lesser-known topic. Studies included targeted pulmonary complications occurring after stem cell transplantation in humans, and were randomized controlled trials, cohort studies, and case studies published between January 2011 and 2021. Fifteen intervention features were identified and analyzed for their association with successful or unsuccessful interventions; all 15 studies meeting the inclusion criteria had positive results, with the most consistent benefit coming from clear information on clinical presentation and management. Hematopoietic stem cell transplantation is a therapeutic method introduced for various hematological diseases, whose main objective is to restore hematopoietic function that has been eradicated or affected. The procedure requires a period of chemotherapeutic administration that may lead to infectious and/or non-infectious pulmonary complications requiring follow-up. Non-infectious pulmonary complications include bronchiolitis obliterans, alveolar hemorrhage, fibroelastosis, and pulmonary hypertension. Bronchiolitis obliterans syndrome, an obstructive small-airway disease that reduces lung function, is the most frequent late-onset complication. Diffuse pulmonary hemorrhage is a fatal adverse effect and the most common non-infectious pulmonary complication of acute leukemia, observed within the first weeks after the procedure. Pulmonary hypertension, mainly related to pulmonary veno-occlusive disease, carries a poor prognosis with a 55% mortality rate.