{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:46:21Z","timestamp":1785818781416,"version":"3.56.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    This study evaluates the incidence and clinical impact of late- onset non-infectious pulmonary complications (LONIPCs) in adults undergoing allo-HCT with post-transplant cyclophosphamide (PTCy). In addition, it assesses the prognostic value of pre-transplant pulmonary function tests (PFTs) for overall mortality in this population. A total of 317 consecutive adults transplanted between 2014 and 2024 were retrospectively included. LONIPC occurred in 10.6% of patients. The most frequent diagnoses were cryptogenic organizing pneumonia (COP, 4.1%), bronchiolitis obliterans syndrome (BOS, 5.9%), and pulmonary thromboembolism (0.6%). Risk factors for LONIPC included smoking history, pre-existing bronchial asthma, mismatched donors, and grade III\u2013IV acute GVHD. The diagnosis of LONIPC was strongly associated with adverse outcomes in both univariate (OS: HR 9.37,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&amp;lt;\u00a00.001; NRM: HR 4.19,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.001) and multivariate analyses (OS: HR 8.07,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0&amp;lt;\u00a00.001; NRM: HR 3.19,\n                    <jats:italic>P<\/jats:italic>\n                    \u00a0=\u00a00.033). Based on pre-transplant PFTs and the HCT-CI scoring system, patients were classified into low- (24.3%), moderate- (35.0%), or high-risk groups (40.7%). High-risk patients had significantly poorer overall survival (OS) (3-year OS: 58.8% vs. 72.0% and 70.0%, P\u00a0=\u00a00.027) and higher non-relapse mortality (NRM) (3-year NRM: 19.0% vs. 7.9% and 15.1%) compared with those in the low- and intermediate-risk groups. No differences were observed regarding pre-transplant PFTs between patients developing LONIPC and those who did not. In conclusion, the incidence of LONIPC occurs in 10% of adults undergoing allo-HCT with PTCy. Its diagnosis, as well as the presence of significant pre-transplant PFT abnormalities, were associated with worse outcomes, underscoring their prognostic importance in the contemporary PTCy-based allo-HCT setting.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1875293","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T04:27:17Z","timestamp":1785817637000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Late onset non-infectious pulmonary complications and pre-transplant pulmonary function as prognostic factors in allo-HCT using post-transplant cyclophosphamide"],"prefix":"10.3389","volume":"17","author":[{"given":"M\u00f3nica","family":"Molina Mart\u00ednez","sequence":"first","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paloma","family":"Ortiz Ca\u00f1as","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Hematology Department, Hospital Universitario Cl\u00ednico San Carlos","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Su\u00e1rez-Lled\u00f3","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gorka","family":"Pinedo","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Hematology Department, Hospital Universitario de Cruces","place":["Bilbao, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ares","family":"Guardia","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Guardia","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Moreno","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Sol\u00e9","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Charry","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Cid","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel","family":"Lozano","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario de Cruces","place":["Bilbao, Spain"]},{"name":"Apheresis and Cellular Therapy Unit, Hemotherapy and Hemostasis Department, Institute of Cancer and Blood Diseases (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rosi\u00f1ol","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enric","family":"Carreras","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3 i Institut de Reserca Josep Carreras Contra la Leuc\u00e8mia","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Fern\u00e1ndez-Avil\u00e9s","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"Agust\u00ed","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"Pneumology Deparment, Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Rovira","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Queralt","family":"Salas","sequence":"additional","affiliation":[{"name":"Hematopoietic Transplantation Unit and Hematology Department, Clinical Institute of Hematology and Oncology (ICAMS), Hospital Cl\u00ednic de Barcelona","place":["Barcelona, Spain"]},{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"University of Barcelona","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-022-01691-w","article-title":"Indications for haematopoietic cell transplantation for haematological diseases, solid tumours and immune disorders: current practice in Europe, 2022","volume":"57","author":"Snowden","year":"2022","journal-title":"Bone Marrow Transplant"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41409-025-02524-2","article-title":"The 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