{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T08:03:09Z","timestamp":1791446589828,"version":"4.3.3"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Bronchiolitis obliterans (BO) is a chronic obstructive lung disease affecting bronchioles and smaller airways, often secondary to infection, hematopoietic cell transplantation (HCT), or lung transplantation. Despite its associated morbidity and mortality post\u2010HCT, no standard treatment exists. This systematic review aimed to compare treatment outcomes for post\u2010HCT BO in children. Eligible studies were retrieved from PubMed, Scopus, and Web of Science using terms \u201cbronchiolitis obliterans\u201d and \u201chematopoietic stem cell transplantation,\u201d including clinical trials, cohorts, cross\u2010sectional studies, case reports, and case series. We analyzed treatment response, pulmonary function improvement, and survival. No significant differences were observed in response between treatment categories (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&gt;\u00a00.18); however, complex multidrug or cell\u2010based regimens showed the highest overall response (66%). Immunosuppressive regimens had the highest non\u2010response rate (42%), possibly due to treatment bias. FEV1 change was not statistically different (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.33), but FAM (corticosteroids, macrolide antibiotics, and leukotriene receptor antagonists)\u2010based and systemic steroid regimens showed numerically better improvement. Survival differed significantly between treatment groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a00.01), highest with FAM\u2010based and lowest with immunosuppressive regimens. These findings suggest clinical benefits from advanced or FAM\u2010based therapies, especially in milder cases. Further large\u2010scale studies are needed to confirm these results.\n                  <\/jats:p>","DOI":"10.1111\/ctr.70274","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T17:45:31Z","timestamp":1755020731000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treatment Options for Bronchiolitis Obliterans Secondary to Hematopoietic Cell Transplantation in Children: A Systematic Review"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2629-1832","authenticated-orcid":false,"given":"Amirali","family":"Kalantari","sequence":"first","affiliation":[{"name":"Pediatric Cell and Gene Therapy Research Center Gene, Cell &amp; Tissue Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9658-6354","authenticated-orcid":false,"given":"Zahra","family":"Karimizadeh","sequence":"additional","affiliation":[{"name":"Pediatric Cell and Gene Therapy Research Center Gene, Cell &amp; Tissue Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9473-3632","authenticated-orcid":false,"given":"Maryam","family":"Behfar","sequence":"additional","affiliation":[{"name":"Pediatric Cell and Gene Therapy Research Center Gene, Cell &amp; Tissue Research Institute Tehran University of Medical Sciences  Tehran Iran"},{"name":"Children's Medical Center Pediatric Center of Excellence Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-079X","authenticated-orcid":false,"given":"Amir Ali","family":"Hamidieh","sequence":"additional","affiliation":[{"name":"Pediatric Cell and Gene Therapy Research Center Gene, Cell &amp; Tissue Research Institute Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_2_15_2_1","first-page":"1379","volume-title":"Robbins & Cotran Pathologic Basis of Disease","author":"Kumar V.","year":"2021"},{"key":"e_1_2_15_3_1","volume-title":"Robbins Basic Pathology","author":"Rosen R. S. L.","year":"2018"},{"key":"e_1_2_15_4_1","volume-title":"Nelson Textbook of Pediatrics","author":"Kliegman R.","year":"2024"},{"key":"e_1_2_15_5_1","volume-title":"Nelson Essentials of Pediatrics","author":"Marcdante K. J.","year":"2023"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ced.13969"},{"key":"e_1_2_15_7_1","volume-title":"ScienceDirect. Lanzkowsky's Manual of Pediatric Hematology and Oncology","author":"Fish J. D.","year":"2022"},{"key":"e_1_2_15_8_1","volume-title":"Nathan and Oski's Hematology and Oncology of Infancy and Childhood","author":"Orkin S. H.","year":"2015"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2013.17"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705637"},{"key":"e_1_2_15_11_1","article-title":"Critical Appraisal Tools","author":"Joanna Briggs Institute","journal-title":"JBI Global"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704985"},{"issue":"11","key":"e_1_2_15_13_1","first-page":"977","article-title":"Clinical Analysis of Lung Transplantation in Eight Patients With Obstructive Bronchiolitis Syndrome After Hematopoietic Stem Cell Transplantation","volume":"38","author":"Wang L. L.","year":"2017","journal-title":"Zhonghua Xue Ye Xue Za Zhi = Zhonghua Xueyexue Zazhi"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.197"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e3181d32184"},{"issue":"2","key":"e_1_2_15_16_1","first-page":"124","article-title":"Obstructive Lung Disease After Allogenic Stem Cell Transplantation in Children","volume":"61","author":"Alonso Riofr\u00edo R.","year":"2004","journal-title":"Anales de Pediatria"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.5603\/AHP.a2023.0023"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2008.19"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24801"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.2249484"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31008"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2010.01357.x"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.33"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-023-03498-y"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.12.172"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24652"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/petr.13155"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1182\/bloodadvances.2024014000"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2021.668825"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2033122"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.2025.211.Abstracts.A1133"},{"key":"e_1_2_15_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2015.120"},{"key":"e_1_2_15_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/5852827"},{"key":"e_1_2_15_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-023-03498-y"},{"key":"e_1_2_15_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2019.09.039"},{"issue":"1","key":"e_1_2_15_36_1","first-page":"341","article-title":"Clinical Observation on the Safety and Efficacy of Umbilical Cord Mesenchymal Stem Cells in the Treatment of Bronchiolitis Obliterans After Allogeneic Haematopoietic Stem Cell Transplantation","volume":"40","author":"Li Z.","year":"2024","journal-title":"Biotechnology and Genetic Engineering Reviews"},{"key":"e_1_2_15_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2009.08.029"},{"key":"e_1_2_15_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2018.04.012"},{"key":"e_1_2_15_39_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00185-2022"},{"key":"e_1_2_15_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25617"},{"key":"e_1_2_15_41_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm-22-2517"},{"key":"e_1_2_15_42_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0059202"},{"key":"e_1_2_15_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00161-4"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70274","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70274","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T11:15:38Z","timestamp":1783941338000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1111\/ctr.70274"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70274","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"assertion":[{"value":"2025-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70274"}}