BEAC induction regimen and prior thoracic radiotherapy increases the risk of ASCT associated pneumonitis

High-dose chemotherapy (HDT) followed by autologous stem cell transplant (ASCT) has been standard of care in the treatment of relapsed and refractory lymphoma. Some severe toxicities are associated with this treatment modality. Pulmonary toxicity is one of these significant adverse effects and a potential cause of treatment related mortality. In this retrospective study we report the incidence, risk factors and outcome of treatment-induced pneumonitis in 286 lymphoma patients receiving HDT followed by ASCT. The cumulative incidence of treatment-induced pneumonitis was 4,6 % and occurred in 11/286 patients. 3 months incidence rate was 2,6 %. Most of the patients diagnosed with treatment-induced pneumonitis had received BEAC as HDT regimen. The risk of treatment-induced pneumonitis was higher if HDT-ASCT was given in later treatment lines. Also, a prior thoracic radiotherapy as part of first line treatment was associated with higher risk for pneumonitis after HDT-ASCT. In two patients the pneumonitis did not response to high dose steroid treatment. This study is providing new information about the incidence of pneumonitis associated with HDT-ASCT and its risk factors, which might be useful to take into consideration during and after treatment with HDT-ASCT.