Take a Breath! Managing Breathing Problems after Transplant

Summary: Chronic graft-versus-host disease (GVHD) is a common complication after a transplant using donor stem cells (allogeneic transplant) that target many organs, including the lungs. Learn who’s at risk of developing chronic GVHD in the lungs, how it affects breathing and therapies available to treat it.
Presenter: Greg Yanik MD, University of Michigan
Many thanks to Sanofi whose support helped make this Survivorship Symposium possible.
To read the transcript, go to:
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Highlights
(03:36): Pneumonia simply means that there is inflammation or irritation in the lungs. Not all pneumonias are due to infection.
(05:07): If infectious pneumonia persists long enough, it can cause scarring in the lungs and lead to non-infectious pneumonia which then leads to more lung infections.
(08:05): Lung GVHD, typically occurs six to 12 months after transplant. It causes scarring that obstructs the airways. Air can get into the lungs but can’t get back out.
(08:55): Lung GVHD is also called bronchiolitis obliterans or BOS. Symptoms include shortness of breath, chronic cough and fatigue.
(10:31): There are two types of GVHD: acute and chronic. Lung GVHD occurs in patients who have chronic GVHD, not acute GVHD.
(20:50): Early diagnosis of lung GVHD is critical. The survival rate for patients whose lung GVHD is caught early is over 90%. For those who are diagnosed later, after the lungs are very scarred, have a much lower survival rate.
(26:36): At-home, hand-held pulmonary function testing (PFT) is being studied to help catch lung GVHD early.
(29:00): New CAT scan technology color codes the lungs, making it easier to detect areas of damage and catch lung GVHD early.
(32:39): Current treatments for lung GVHD include inhaled steroids and FAM therapy..
(35:59): Exercise is one of the most powerful ways to combat breathing problems after transplant.
May 2024, Part of the Virtual Celebrating a Second Chance at Life Survivorship Symposium 2024
Presentation is 40 minutes long with 19 minutes of Q & A.
Key Points
Lung graft-versus-host disease (also called bronchiolitis obliterans or BOS) develops in 10% to 20% of patients who have chronic GVHD in other parts of their body.
Risk factors for developing chronic lung GVHD include prior acute GVHD; a viral infection during the first three months after transplant that never resolves; and low pulmonary function prior to transplant.
Pulmonary function tests (PFTs) performed early after transplant are crucial to the diagnosis and successful treatment of lung GVHD.
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