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Int J Hematol. 2011 Mar;93(3):383-8. doi: 10.1007/s12185-011-0797-8. Epub

2011 Mar 1.

Retrospective analysis of paranasal sinusitis

in patients receiving hematopoietic stem

cell transplantation.

Won YW,Yi SY,Jang JH, Kim K, Kim SJ, Kim WS,Jung CW, Kim DH.

Source

Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center,

Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul 135-

710, Republic of Korea.

Abstract

Hematopoietic stem cell transplantation (HSCT) recipients frequently develop opportunistic

infections, including paranasal sinusitis. Paranasal sinusitis in post-transplant recipients can

be complicated by life-threatening infections. Accordingly, we analyzed risk factors for

development of paranasal sinusitis following HSCT and reviewed our experiences for

analysis of the role of management of paranasal sinusitis prior to HSCT. A retrospective

review was performed for patients who had received HSCT at Samsung Medical Center

(Seoul, South Korea) from 1996 to 2003. A total of 252 patients were analyzed. While 23patients (9.1%) had sinusitis prior to HSCT, its occurrence rate increased to 15.9% after

HSCT. Patients with pre-HSCT sinusitis showed a high occurrence rate of post-HSCT

sinusitis (34.8 vs. 14.0%, p = 0.015). However, when pre-HSCT radiological abnormality

alone was compared to no evidence of sinusitis prior to HSCT, there was no significant

difference in the occurrence rates of post-HSCT sinusitis (15.6 vs. 12.8%, p = 0.541).

Although statistical significance was not demonstrated, the occurrence rate of post-HSCT

sinusitis was relatively low in patients who received autologous HSCT compared to those

who received allogeneic HSCT (11.3 vs. 20.3%, p = 0.060). Use of total body irradiation and

presence of graft-versus-host disease did not correlate with development of post-HSCT

sinusitis. Compared to the observation group, occurrence of post-HSCT sinusitis showed a

slight reduction with medical or surgical intervention targeting radiological abnormalities ofthe paranasal sinuses (10.0 vs. 25.0%, p = 0.057). In conclusion, pre-HSCT sinusitis and

allogeneic HSCT are associated with development of post-HSCT sinusitis. Although

asymptomatic radiological abnormalities of the sinus do not increase the risk of post-HSCT

sinusitis, optimal treatment prior to HSCT tends to decrease the risk of post-HSCT sinusitis.

http://www.ncbi.nlm.nih.gov/pubmed/21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Won%20YW%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Yi%20SY%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Jang%20JH%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20K%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20SJ%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20WS%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Jung%20CW%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20DH%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed/21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Won%20YW%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Yi%20SY%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Jang%20JH%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20K%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20SJ%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20WS%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Jung%20CW%5BAuthor%5D&cauthor=true&cauthor_uid=21360008http://www.ncbi.nlm.nih.gov/pubmed?term=Kim%20DH%5BAuthor%5D&cauthor=true&cauthor_uid=21360008

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Bone Marrow Transplant. 2002 Feb;29(3):257-61.

Risk factors for post-stem cell transplant

sinusitis.Thompson AM, Couch M, Zahurak ML,Johnson C, Vogelsang GB.

Source

Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD,

USA.

Abstract

An understanding of the factors that place the post-transplant patient at increased risk forsinusitis would help identify patients likely to develop disease and possibly allow for

interventions that would decrease the incidence or severity of sinus disease. This

retrospective study investigates the ability of screening paranasal sinus computed

tomographic scans (CTs), clinical history, and potential risk factors for sinusitis, including

history of tobacco use, history of allergies or asthma, IgG level, history of sinusitis, remission

status and acute graft-versus-host disease (GVHD) to predict post-transplant sinusitis.

Medical records and sinus CTs of 100 allogeneic bone marrow recipients were reviewed.

There was no increased risk of developing sinusitis post SCT for patients with significant

disease on screening CT, symptoms at time of transplant, a history of tobacco use, asthma or

allergies, low IgG level, history of sinusitis or for patients at high risk of relapse. Patients

with GVHD were 4.3 times more likely than patients without GVHD to develop sinusitis post

transplant (95% CI: 1.7-11.0, P = 0.002). Acute GVHD places patients at greater risk of

developing sinus infections.

http://www.ncbi.nlm.nih.gov/pubmed/11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Thompson%20AM%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Couch%20M%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Zahurak%20ML%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Johnson%20C%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Vogelsang%20GB%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed/11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Thompson%20AM%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Couch%20M%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Zahurak%20ML%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Johnson%20C%5BAuthor%5D&cauthor=true&cauthor_uid=11859399http://www.ncbi.nlm.nih.gov/pubmed?term=Vogelsang%20GB%5BAuthor%5D&cauthor=true&cauthor_uid=11859399