Volume 155, Issue 1, Pages e1-e4 (January 2019)

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Volume 155, Issue 1, Pages e1-e4 (January 2019) Tamibarotene for the Treatment of Bronchiolitis Obliterans Associated With Chronic Graft-vs-Host Disease Satoshi Watanabe, MD, PhD, Ken Ishiyama, MD, PhD, Keigo Saeki, MD, Noriyuki Ohkura, MD, PhD, Kazuo Kasahara, MD, PhD, Shinji Nakao, MD, PhD CHEST Volume 155, Issue 1, Pages e1-e4 (January 2019) DOI: 10.1016/j.chest.2018.08.1052 Copyright © 2018 American College of Chest Physicians Terms and Conditions

Figure 1 Mucocutaneous manifestations, chest CT scan findings, and lung biopsy specimen findings from the patient. A, Oral mucositis was visible on the tongue and the upper and lower lips before tamibarotene treatment. These were improved after treatment. B, The patient’s body showed erythematous macules before treatment, which disappeared after treatment. C, Inspiratory chest CT scan revealed bronchial thickness and bronchiectasis, and expiratory CT scan revealed slight mosaic perfusion. D, Histologically, the lung biopsy specimen showed epithelial injury and fibroproliferative constriction of the bronchiole, consistent with bronchiolitis obliterans (Masson trichrome stain). CHEST 2019 155, e1-e4DOI: (10.1016/j.chest.2018.08.1052) Copyright © 2018 American College of Chest Physicians Terms and Conditions

Figure 2 Time course of FEV1 assessed before and after the start of tamibarotene administration. HSCT = hematopoietic stem cell transplantation; ICS = inhaled corticosteroids; LABA = long-acting β2-agonist; LAMA = long-acting muscarinic antagonist; LTRA = leukotriene receptor antagonist; TAC = tacrolimus; VATS = video-assisted thoracoscopic surgery. CHEST 2019 155, e1-e4DOI: (10.1016/j.chest.2018.08.1052) Copyright © 2018 American College of Chest Physicians Terms and Conditions