Research Article

Cytomegalovirus pneumonia and Cryptogenic organizing pneumonia following pediatric stem cell transplantation for leukemia

Zuhre Kaya*, Tuba Sismanlar, Ayse Tana Aslan, Oznur Konus Boyunaga, Isıl Fidan Balcı, İdil Yenicesu and Ulker Kocak

Published: 09/12/2017 | Volume 1 - Issue 1 | Pages: 014-018


Background: Knowledge of pulmonary complications (PCs) in children after hematopoetic stem cell transplantation (allo-HSCT) is limited; most data are from adult studies.

Case: We describe a 8 year old girl with high risk acute myeloid leukemia who developed graft versus host disease (GVHD) on Day 20, Cytomegalovirus (CMV) pneumonia on Day 50 and Cryptogenic organizing pneumonia (COP) on Day 170 after allo-HSCT.

Discussion: Cryptogenic organizing pneumonia is a rare noninfectious PCs that can be idiopathic or have several risk factors as a secondary causes, such as viral respiratory infections, drugs, GVHD and allo-HSCT. Viral respiratory infections and alloimmune lung syndromes have been reported in a few patients who have undergone transplantation.

Conclusion: Transplant physicians should be kept in mind for the development of alloimmune lung syndrome in the form of COP following CMV pneumonia in patients after allo- HSCT

Read Full Article HTML DOI: 10.29328/journal.jhcr.1001003 Cite this Article


  1. Roychowdhury M, Pambuccian SE, Aslan DL, Jessurun J, Rose AG, et al. Pulmonary complications after bone marrow transplantation:an autopsy study from a large transplantation center. Arch Pathol Lab Med.2005; 129: 366-371. Ref.:
  2. Michelson PH, Goyal R, Kurland G. Pulmonary complications of haematopoietic cell transplantation in children. Paediatr Respir Rev. 2007; 8: 46-61. Ref.:
  3. Kaya Z, Weiner DJ, Yılmaz D, Rowan J, Goyal RK. Lung function, pulmonary complications, and mortality after allogeneic blood and marrow transplantation in children. Biol Blood Marrow Transplant. 2009; 15: 817-826. Ref.:
  4. Versyluys AB, Rossen JW, Van Ewijk B, Schuurman R, Bierings MB, et al. Strong association between respiratory viral infection early after hematopoietic stem cell transplantation and the developments of life threatening acute and chronic alloimmune lung syndromes. Biol Blood Marrow Transplant. 2010;16:782-791. Ref.:
  5. Epler GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med. 2001; 161: 158-164. Ref.:
  6. Chien J, Chan CK, Chamberlain D, Patterson B, Fyles G, et al. CMV pneumonia in allogeneic bone marrow transplantation. An immunopathologic process?. Chest. 1990; 98: 1034-1037. Ref.:
  7. Baron FA, Hermanne JP, Dowlati A, Weber T, Thiry A, et al. Bronchiolitis obliterans organizing pneumonia and ulcerative colitis after allogeneic bone marrow transplantation. Bone Marrow Transplant. 1998; 21: 951-954. Ref.:
  8. Honda J, Yonemitsu J, Kitajima H, Yosida N, Fumirori T, et al. Clinical utility of capillary polymerase chain reaction for diagnosis of Cytomegalovirus pneumonia. Scand J Infect Dis. 2001; 33: 702-705. Ref.:
  9. Siddigui MT, Garrity ER, Husain AN. Bronchiolitis obliterans organizing pneumonia like reactions: a nonspesific response or an atypical form of rejection or infections in lung allograft recipients?. Hum Pathol. 1996; 27: 714-719.
  10. Jacques J, Dallocchio A, Dickson Z, Bocquentin F, Jebali H, et al. An unusual pulmonary complications of CMV infections in renal transplant recipients. NDT Plus. 2008; 1: 236-238. Ref.:
  11. Freudenberger TD, Madtes DK, Curtis JR, Cummings P, Storer BE, et al. Association between acute and chronic graft versus host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood. 2003; 102: 3822-3828. Ref.:
  12. Ditschkowski M, Elmaağaçlı AH, Trenschel R, Pecency R, Koldehoff M, et al. T-cell depletion prevents from bronchiolitis obliterans and bronchiolitis obliterans with organizing pneumonia after allogeneic hematopoetic stem cell transplantation with related donors. Haematologica. 2007; 92: 558-561. Ref.:
  13. Garrod AS, Goyal RK, Weiner DJ. Sirolimus induced interstitial lung disease following pediatric stem cell transplantation. Pediatr Transplant. 2015; 19: 75-77. Ref.:
  14. Morelon E, Stern M, Israel-Biet D, Correas JM, Danel C, et al. Characteristics of sirolimus associated interstitial pneumonitis in renal transplant patients. Transplantation. 2001; 72: 787-790. Ref.:
  15. Yilmaz S, Akinci Ozyurek B, Erdogan Y, Cirit Kocer B, Demirag F, et al. Retrospective evaluation of patients with organizing pneumonia: is Cryptogenic organizing pneumonia different from secondary organizing pneumonia? Tuberk Toraks. 2017; 65: 1-8. Ref.: