Chronic graft-versus-host disease (cGvHD) is a common complication after allogeneic haematopoietic stem cell transplantation, characterised by a broad disease spectrum that can affect virtually any organ. Although pulmonary cGvHD is a less common manifestation, it is of great concern due to its severity and poor prognosis. Optimal management of patients with pulmonary cGvHD is complicated and no standardised approach is available. The purpose of this joint European Respiratory Society (ERS) and European Society for Blood and Marrow Transplantation task force was to develop evidence-based recommendations regarding the treatment of pulmonary cGvHD phenotype bronchiolitis obliterans syndrome in adults. A multidisciplinary group representing specialists in haematology, respiratory medicine and methodology, as well as patient advocates, formulated eight PICO (patient, intervention, comparison, outcome) and two narrative questions. Following the ERS standardised methodology, we conducted systematic reviews to address these questions and used the Grading of Recommendations Assessment, Development and Evaluation approach to develop recommendations. The resulting guideline addresses common therapeutic options (inhalation therapy, fluticasone-azithromycin-montelukast, imatinib, ibrutinib, ruxolitinib, belumosudil, extracorporeal photopheresis and lung transplantation), as well as other aspects of general management, such as lung functional and radiological follow-up and pulmonary rehabilitation, for adults with pulmonary cGvHD phenotype bronchiolitis obliterans syndrome. These recommendations include important advancements that could be incorporated in the management of adults with pulmonary cGvHD, primarily aimed at improving and standardising treatment and improving outcomes.

慢性移植物抗宿主病（cGvHD）是异基因造血干细胞移植后的常见并发症，其特点是疾病谱广泛，几乎可以影响任何器官。尽管肺部cGvHD是一种不太常见的表现，但由于其严重性和预后不良而备受关注。肺部 cGvHD 患者的最佳治疗很复杂，并且没有可用的标准化方法。欧洲呼吸学会 (ERS) 和欧洲血液与骨髓移植学会联合工作组的目的是针对成人肺部 cGvHD 表型闭塞性细支气管炎综合征的治疗制定基于证据的建议。由血液学、呼吸医学和方法学专家以及患者倡导者组成的多学科小组制定了八个 PICO（患者、干预、比较、结果）和两个叙述性问题。遵循 ERS ​​标准化方法，我们进行了系统审查来解决这些问题，并使用建议评估、制定和评估分级方法来制定建议。由此产生的指南涉及常见的治疗选择（吸入疗法、氟替卡松-阿奇霉素-孟鲁司特、伊马替尼、依鲁替尼、鲁索替尼、贝鲁莫舒地尔、体外光采术和肺移植），以及一般管理的其他方面，例如肺功能和放射学随访和肺康复，适用于患有肺 cGvHD 表型闭塞性细支气管炎综合征的成人。这些建议包括可纳入成人肺 cGvHD 管理的重要进展，主要旨在改进和标准化治疗以及改善结果。