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Objective <p>To observe and analyse the characteristic endoscopic findings and clinical significance of bronchiolitis obliterans syndrome(BOS) after hematopoietic stem cell transplantation(HSCT) under ultrathin bronchoscopy.</p> Methods <p>The clinical data and characteristic images under bronchoscopy of 51 patients diagnosed with BOS after HSCT in the Department of Respiratory and Critical Care Medicine of the Fourth Affiliated Hospital of Soochow University from December 2020 to December 2023 were collected. Pearson’s correlation was used to analyse the correlation between the occlusion level with the percent predicted forced expiratory volume in 1 s (FEV1% pred) and the percent predicted of forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC); Kaplan-Meier survival analysis and COX regression analysis were used to analyze the relationship between the characteristics under endoscopy and survival. </p> Results <p>There were four different manifestations of bronchioles under bronchoscopy: (1)membranous occlusion, (2)scar hyperplasia occlusion; (3)bronchial concentric stenosis, (4)only increased mucus. Spearman’s correlation coefficients of occlusion level with FEV1%pred and FEV1/FVC were 0.40 and 0.41, respectively. The closer the occlusion level was to the central airway, the lower the FEV1%pred and FEV1/FVC, and the two were positively correlated. The cut-off values of pulmonary function indices in the occluded population, FEV1%pred &lt; 49.85% and FEV1/FVC &lt; 62.23%. COX regression analyses showed that bronchial occlusion level≤ 8th-level bronchus(HR = 12.882, 95% CI: 1.595–104.030, <i>p</i> = 0.016) was an important risk factor affecting the survival of BOS patients. </p> Conclusion <p>Patients with BOS can present in various forms of bronchial occlusion; the bronchial occlusion level was positively correlated with the decline in pulmonary function; the level of occluded bronchi being ≤ 8th-level bronchus is a risk factor affecting the survival of BOS patients.</p>

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Characteristics and significance of bronchiolitis obliterans syndrome after hematopoietic stem cell transplantation at bronchoscopy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月31日

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  • Qingxia Chen,
  • Zhenyu Yang,
  • Wei Ge,
  • Qinqin Yang,
  • Wenying Pan,
  • Jing Li,
  • Yijie Lu,
  • Daxiong Zeng,
  • Junhong Jiang

摘要

Objective

To observe and analyse the characteristic endoscopic findings and clinical significance of bronchiolitis obliterans syndrome(BOS) after hematopoietic stem cell transplantation(HSCT) under ultrathin bronchoscopy.

Methods

The clinical data and characteristic images under bronchoscopy of 51 patients diagnosed with BOS after HSCT in the Department of Respiratory and Critical Care Medicine of the Fourth Affiliated Hospital of Soochow University from December 2020 to December 2023 were collected. Pearson’s correlation was used to analyse the correlation between the occlusion level with the percent predicted forced expiratory volume in 1 s (FEV1% pred) and the percent predicted of forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC); Kaplan-Meier survival analysis and COX regression analysis were used to analyze the relationship between the characteristics under endoscopy and survival.

Results

There were four different manifestations of bronchioles under bronchoscopy: (1)membranous occlusion, (2)scar hyperplasia occlusion; (3)bronchial concentric stenosis, (4)only increased mucus. Spearman’s correlation coefficients of occlusion level with FEV1%pred and FEV1/FVC were 0.40 and 0.41, respectively. The closer the occlusion level was to the central airway, the lower the FEV1%pred and FEV1/FVC, and the two were positively correlated. The cut-off values of pulmonary function indices in the occluded population, FEV1%pred < 49.85% and FEV1/FVC < 62.23%. COX regression analyses showed that bronchial occlusion level≤ 8th-level bronchus(HR = 12.882, 95% CI: 1.595–104.030, p = 0.016) was an important risk factor affecting the survival of BOS patients.

Conclusion

Patients with BOS can present in various forms of bronchial occlusion; the bronchial occlusion level was positively correlated with the decline in pulmonary function; the level of occluded bronchi being ≤ 8th-level bronchus is a risk factor affecting the survival of BOS patients.