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Transplant Toxicities

Pulmonary complications in hematopoietic SCT: a prospective study

Bone Marrow Transplantation volume 49, pages 1293–1299 (2014)Cite this article

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Abstract

Pulmonary complications are common and often lethal in hematopoietic SCT recipients. The objective of this prospective interventional study was to evaluate the etiology, diagnostic procedures, risk factors and outcome of pulmonary complications in a cohort of hematopoietic SCT recipients followed up for 1 year. For patients suffering from a pulmonary complication, a diagnostic algorithm that included non-invasive and bronchoscopic procedures was performed. We identified 73 pulmonary complications in 169 patients: 50 (68%) were pneumonias; 21 (29%) were non-infectious complications and 2 (3%) were undiagnosed. Viruses (particularly Rhinovirus) and bacteria (particularly P. aeruginosa) (28 and 26%, respectively) were the most common causes of pneumonia. A specific diagnosis was obtained in 83% of the cases. A non-invasive test gave a specific diagnosis in 59% of the episodes. The diagnostic yield of bronchoscopy was 67 and 78% in pulmonary infections. Early bronchoscopy (⩽5 days) had higher diagnostic yield than late bronchoscopy (78 vs 23%; P=0.02) for pulmonary infections. Overall mortality was 22 and 32% of all fatalities were due to pulmonary complications. Pulmonary complications are common and constitute an independent risk factor for mortality, stressing the importance of an appropriate clinical management.

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Acknowledgements

CML and CA have contributed in the study design, in the acquisition, analysis and interpretation of data and writing of the manuscript. AT and MR have participated in the study design and in the revision of the article. MAM, JPdlB, MS and JM have contributed in the interpretation of data. RD has contributed in the acquisition of data. AG conducted the statistical analysis. The project was supported by FIS-ISCIII (Fondo de Investigación Sanitaria, Instituto de Salud Carlos III) (PI10/00507), SEPAR 2010 and FUCAP 2010. CML was supported by a clinical research grant from SEPAR 2012 and Hospital Clínic Barcelona (Beca Josep Font 2009-2012).

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Authors and Affiliations

  1. Pneumology Department, Hospital Clínic, Barcelona, Spain

    C M Lucena, A Torres, R Domingo & C Agustí

  2. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain

    C M Lucena, A Torres, M Rovira, M Sánchez, R Domingo, A Gabarrus, J Mensa & C Agustí

  3. University of Barcelona, Barcelona, Spain

    A Torres

  4. Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), Barcelona, Spain

    A Torres

  5. Hematology Department, HSCT unit, Hospital Clínic, Barcelona, Spain

    M Rovira

  6. Microbiology Department, Hospital Clínic, Barcelona, Spain

    M A Marcos & J P de la Bellacasa

  7. Radiology Department, Hospital Clínic, Barcelona, Spain

    M Sánchez

  8. Infectious Diseases Department, Hospital Clínic, Barcelona, Spain

    J Mensa

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  1. C M Lucena
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  2. A Torres
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  3. M Rovira
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Correspondence to C Agustí.

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Lucena, C., Torres, A., Rovira, M. et al. Pulmonary complications in hematopoietic SCT: a prospective study. Bone Marrow Transplant 49, 1293–1299 (2014). https://doi.org/10.1038/bmt.2014.151

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