ABSTRACT
Marrow transplantation is being investigated in the treatment of many life-threatening immunological, hematological, and oncological disorders of childhood. The impact of marrow transplantation on this large number of diseases is reduced, however, by one major complication — graft-vs.-host disease. The incidence and severity of this immunological reaction of the transplanted marrow graft against its host4 are related to the degree of genetic mismatch between donor and recipient. The chapter deals exclusively with pneumonitis in bone marrow transplant recipients — its pathogenesis, clinical manifestations, diagnosis, management, and prognosis. Interstitial pneumonitis, whether of infectious or iatrogenic origin, remains a major lethal complication following marrow transplantation. The diagnosis of interstitial pneumonitis can be made on clinical presentation and chest radiograph. The major predisposing factors to infectious interstitial pneumonias change with time following transplantation. The pathogenesis of both idiopathic and infectious interstitial pneumonitis involves several interacting factors.
