Clinical Usefulness of Bronchoalveolar Lavage in the Management of Pulmonary Infiltrates in Adults with Hematological Malignancies and Stem Cell Transplantation
| Autor: | Agustín Languasco, Cristina Videla, Fabián Herrera, Pablo Bonvehi, Pablo Rodríguez, Silvia Relloso, Elena Temporiti, Laura Jorge, D. Torres |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Bronchoalveolar lavage medicine.medical_specialty Hematologic malignancy medicine.medical_treatment 030106 microbiology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Adverse effect Acute leukemia Chemotherapy medicine.diagnostic_test lcsh:RC633-647.5 business.industry Pulmonary infiltrate Stem cell transplantation lcsh:Diseases of the blood and blood-forming organs Hematology bronchoalveolar lavage pulmonary infiltrate hematologic malignancy stem cell transplantation Transplantation Infectious Diseases 030228 respiratory system Pulmonary infiltrates Original Article Stem cell business Empiric treatment |
| Zdroj: | Mediterranean Journal of Hematology and Infectious Diseases Mediterranean Journal of Hematology and Infectious Diseases, Vol 12, Iss 1 (2020) |
| ISSN: | 2035-3006 |
| Popis: | Introduction: Pulmonary complications are frequent in patients with hematologic malignancies and stem cell transplantation. Regardless of the microbiological usefulness of bronchoalveolar lavage (BAL), little information exists on both its benefits as a guide for therapeutic decisions and its impact on patients’ clinical outcome. Methods: A prospective observational single center study was performed between July 2011 and July 2015. Consecutive episodes of pulmonary infiltrates were analyzed in subjects over 18 years of age who presented hematologic malignancies and underwent chemotherapy or stem cell transplantation. Results: Ninety-six episodes of pulmonary infiltrates were analyzed. Acute leukemia was the most frequent underlying condition. Thirty-seven patients (38.5%) received a stem cell transplant. Sixty-one (62.9%) were neutropenic at the moment of inclusion in the study. A definitive etiologic diagnosis was obtained in 41 cases (42.7%), where infection accounted for the vast majority of causes (33 cases, 80.5%). Definitive diagnosis was reached by non-invasive methods in 13 cases (13.5%). BAL was performed in 47 cases, and led to a diagnosis in 40.4% of the cases. BAL results led to therapeutic changes in 27 cases (57.4%), including the addition of new antimicrobials to empiric treatments in 10. Regarding BAL’s safety, 2 patients experienced minor adverse events and 1 a severe adverse event; no procedure-related deaths were observed. Conclusions: Infection was the leading cause of pulmonary infiltrates in patients with hematologic malignancies and stem cell transplantation. BAL was a useful decision-making diagnostic tool, with minor adverse events |
| Databáze: | OpenAIRE |
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