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Azithromycin in bronchiolitis obliterans syndrome after hematopoietic SCT

Bone Marrow Transplantation volume 47, page 1374 (2012)Cite this article

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We read with great interest the paper by Lam et al.,1 about the absence of significant benefits of a 3 month regimen of azithromycin on the respiratory symptoms and lung function in patients with bronchiolitis obliterans syndrome after hematopoietic SCT. The authors discussed the interest of a longer course of treatment. According to the hypothesis of the benefit of long-term azithromycin regimen, our group has performed an open trial of azithromycin in 10 patients suffering from BOS.2 Azithromycin was initiated at a mean time of 43±26 months after SCT. The mean duration of the treatment was 10 months. We also found no improvement in forced respiratory volume in 1 s, in mid-expiratory flow at 25–75% of vital capacity, in a 6-min walk test. However, 7 out of 10 patients showed a small improvement in cough and sputum. No adverse effect related to azithromycin was observed. In conclusion, like Lam et al. we do not think that azithromycin has shown any clear efficacy in bronchiolitis obliterans syndrome after hematopoietic SCT even after long-term administration. No additional trials seem to be necessary.

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References

  1. Lam DCL, Lam B, Wong MKY, Lu C, Au WY, Tse EWC et al. Effects of azithromycin in bronchiolitis obliterans syndrome after hematopoietic SCT - a randomised double-blinded placebo-controlled study. Bone Marrow Transplant 2011; 46: 1551–1556.

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  2. Lemonnier F, Catherinot E, Neveu H, Couderc LJ, Rivaud E . Long term azithromycin use for bronchiolitis obliterans in ten allogeneic hematopoietic stem cell transplant recipient. European Respiratory Society Meeting. Berlin, Germany. 6 October 2008 Abstract : E1631.

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Authors and Affiliations

  1. Service de Pneumologie, Hôpital Foch, Suresnes, France

    F Lemonnier, E Rivaud, H Neveu, E Catherinot & L-J Couderc

  2. Service d'Hématologie Clinique, Hôpital Necker, Paris, France

    E Catherinot & F Suarez

  3. Service d'Hématologie Clinique, Hôpital Pitié Salpétrière, Paris, France

    N Dhedin

  4. Faculté de Médecine Paris-Ile de France-Ouest, Université Versailles-Saint Quentin en Yvelines, Saint Quentin en Yvelines, France

    L-J Couderc

Authors
  1. F Lemonnier
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  2. E Rivaud
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  3. H Neveu
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  4. E Catherinot
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  5. F Suarez
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  6. N Dhedin
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  7. L-J Couderc
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Corresponding author

Correspondence to F Lemonnier.

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Lemonnier, F., Rivaud, E., Neveu, H. et al. Azithromycin in bronchiolitis obliterans syndrome after hematopoietic SCT. Bone Marrow Transplant 47, 1374 (2012). https://doi.org/10.1038/bmt.2012.23

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