CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION
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...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2020-05-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
| Subjects: | |
| Online Access: | https://mjhid.org/index.php/mjhid/article/view/4167 |
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| author | Laura Jorge Diego Torres Agustín Languasco Pablo Rodriguez Pablo Bonvehí Elena Temporiti Silvia Relloso Cristina Videla Fabián Herrera |
| author_facet | Laura Jorge Diego Torres Agustín Languasco Pablo Rodriguez Pablo Bonvehí Elena Temporiti Silvia Relloso Cristina Videla Fabián Herrera |
| author_sort | Laura Jorge |
| collection | DOAJ |
| description | 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 |
| first_indexed | 2024-12-24T01:00:02Z |
| format | Article |
| id | doaj.art-7855e24301c64e5aa0a4487372cc7b0d |
| institution | Directory Open Access Journal |
| issn | 2035-3006 |
| language | English |
| last_indexed | 2025-02-17T10:14:58Z |
| publishDate | 2020-05-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj.art-7855e24301c64e5aa0a4487372cc7b0d2025-01-02T00:23:28ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062020-05-0112110.4084/mjhid.2020.025CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATIONLaura Jorge0Diego TorresAgustín LanguascoPablo RodriguezPablo BonvehíElena TemporitiSilvia RellosoCristina VidelaFabián Herrera{'en_US': 'Centro de Educación Médica e Investigaciones Clínicas "Norberto Quirno" CEMIC'}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 eventshttps://mjhid.org/index.php/mjhid/article/view/4167bronchoalveolar lavage, pulmonary infiltrate, hematologic malignancy, stem cell transplantation |
| spellingShingle | Laura Jorge Diego Torres Agustín Languasco Pablo Rodriguez Pablo Bonvehí Elena Temporiti Silvia Relloso Cristina Videla Fabián Herrera CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION Mediterranean Journal of Hematology and Infectious Diseases bronchoalveolar lavage, pulmonary infiltrate, hematologic malignancy, stem cell transplantation |
| title | CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION |
| title_full | CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION |
| title_fullStr | CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION |
| title_full_unstemmed | CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION |
| title_short | CLINICAL USEFULNESS OF BROCHOALVEOLAR LAVAGE IN THE MANAGEMENT OF PULMONARY INFILTRATES IN ADULTS WITH HAEMATOLOGICAL MALIGNANCIES AND STEM CELL TRANSPLANTATION |
| title_sort | clinical usefulness of brochoalveolar lavage in the management of pulmonary infiltrates in adults with haematological malignancies and stem cell transplantation |
| topic | bronchoalveolar lavage, pulmonary infiltrate, hematologic malignancy, stem cell transplantation |
| url | https://mjhid.org/index.php/mjhid/article/view/4167 |
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