Diffuse Alveolar Hemorrhage Following Allogeneic Bone Marrow Transplantation in Children*

Ben‐Abraham, Ron; Paret, Gideon; Cohen, R.; Szold, Oded; Cividalli, Gabriel; Toren, Amos; Nagler, Arnon

doi:10.1378/chest.124.2.660

Cited by 42 publications

(55 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Also, in the only patient with DAD, the correct diagnosis resulted from the combination of clinical data, BAL and HRCT findings. The association of DAD with severe GVHD and poor clinical outcome is well described in the literature [4,16] and was also found in our patient. All patients with severe GVHD died, verifying the significant association between severe GVHD (stage III/IV) and death (P=0.02).…”

Section: Discussionsupporting

confidence: 87%

“…However, patients with GVHD did not show a specific pattern of abnormalities on HRCT (Table 2). In the patient with DAD, the pattern on HRCT, severe GVHD and poor clinical outcome are in accordance with reports in the literature [4,16]. In this patient the lung abnormalities were extensive (Fig.…”

Section: Hrctsupporting

confidence: 91%

“…Idiopathic pneumonia syndrome is diagnosed if a patient shows bilateral diffuse parenchymal interstitial/ alveolar infiltrates on chest radiographs and/or CT images with associated hypoxaemia (PaO 2 <70 mmHg, A-aDO 2 >20 mmHg) [15]. The diagnosis of DAD requires fulfilment of the following criteria: diffuse bilateral pulmonary infiltrates, progressively haemorrhagic BAL fluid from at least three separate lobes and haemosiderin-laden macrophages on microscopic examination of the BAL fluid, no improvement with correction of underlying coagulopathy, and/or fluid overload and no evidence of cardiogenic pulmonary oedema [4,16]. BOOP is diagnosed on the basis of the chest radiographic appearance of patchy air-space opacity, foci of air-space consolidation and ground-glass opacity on HRCT images [17][18][19].…”

Section: Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

et al. 2008

View full text Add to dashboard Cite

Background Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versushost disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established. Objective To illustrate different patterns of LONIPCs on HRCT in allogeneic versus autologous BMT in order to investigate the correlation with chronic GVHD (cGVHD). Materials and methods A total of 67 HRCT scans were performed in 24 patients with noninfectious pulmonary disease at least 3 months after BMT (16 allogeneic, 8 autologous). Abnormality patterns and extension on HRCT images were correlated with the clinical outcome and with the severity of cGVHD.Results Of 24 patients, 9 showed LONIPCs (1 autologous, 8 allogeneic). There was a significant association between abnormalities on HRCT and severe cGVHD (P=0.038), with no specific pattern. Prognosis seemed to be related to the severity of cGVHD and not to the extent of abnormalities on HRCT. Conclusion The significant association between abnormalities on HRCT and severe GVHD suggests that LONIPCs can be a pulmonary manifestation of the disease. HRCT is a useful tool when combined with clinical data.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Hrctsupporting

confidence: 91%

Section: Patientsmentioning

confidence: 99%

See 1 more Smart Citation

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

et al. 2008

View full text Add to dashboard Cite

show abstract

“…DAH was diagnosed according to the following criteria: (1) acute hypoxemic respiratory failure, defined as an oxygenation index (arterial partial pressure of oxygen/fraction of inspiration oxygen ratio) <200 mm Hg, which required supplemental oxygen or mechanical ventilation support; (2) multilobar pulmonary infiltrates observed on chest radiographs; (3) bronchoalveolar lavage (BAL) showing progressively bloodier returns from three or more separate subsegmental bronchi, and/or the presence of 20% or more hemosiderin-laden macrophages; (4) no clear bacterial, viral or fungal pathogens detected in the BAL fluid, and (5) no evidence of cardiogenic pulmonary edema based on clinical findings, central venous pressure measurements or cardiac echocardiography [8,9,13]. …”

Section: Methodsmentioning

confidence: 99%

“…Diffuse alveolar hemorrhage (DAH) is found in 2-14% of patients receiving HSCT [1,2,3,4,5,6,7] and it is considered as one of the most severe pulmonary complications. DAH is associated with a 60-83% mortality rate [1,2,3,6,7,8]; therefore, it is important to pay more attention to this complication.…”

Section: Introductionmentioning

confidence: 99%

High-Dose Cyclophosphamide Therapy Associated with Diffuse Alveolar Hemorrhage after Allogeneic Hematopoietic Stem Cell Transplantation

Liu

et al. 2012

Respiration

View full text Add to dashboard Cite

Background: The occurrence of diffuse alveolar hemorrhage (DAH) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare but severe. There are few reports that have examined the correlation between pre-HSCT chemotherapeutic exposure and DAH. Objectives: We examine the role of pre-HSCT chemotherapeutic exposure, conditioning regimens, pre-HSCT comorbidities and transplant-related complications in the development of DAH after allo-HSCT and evaluate the effect of the high-dose corticosteroid strategy on DAH. Methods: A retrospective nested case-control study was designed. Cases with DAH and controls matched for year of allo-HSCT and length of follow-up were identified from a cohort of 597 patients who underwent allo-HSCT between 2006 and 2011 for acute leukemia. Results: Twenty-two patients suffered from DAH; the mean age at the time of presentation was 30.4 years (±12.9) and the mean time to presentation was 7.8 months (±8.1) post-HSCT. The pre-HSCT cyclophosphamide exposure and the cumulative cyclophosphamide dose were significantly higher among the DAH cases compared with the controls, and the cumulative cyclophosphamide dose of ≥5 g/m² was independently associated with DAH (OR = 3.4, p = 0.030). High-dose corticosteroid treatment did not significantly improve survival. Conclusions: From these results we can identify patients who are at a higher risk of developing DAH after allo-HSCT, and we found that high-dose corticosteroid therapy may not alter the poor outcome associated with this syndrome.

show abstract

Pulmonary dysfunction in pediatric hematopoietic stem cell transplant patients: Non‐infectious and long‐term complications

Gower

Collaco

Mogayzel

2006

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Pulmonary complications are among the most frequently encountered sequelae of pediatric hematopoietic stem cell transplantation (HSCT). Non-infectious complications are becoming increasingly more common in this unique population. This review addresses the diagnosis and management of non-infectious manifestations of lung disease in pediatric HSCT patients and briefly discusses the long-term pulmonary function of childhood HSCT survivors.

show abstract

Diffuse Alveolar Hemorrhage Following Allogeneic Bone Marrow Transplantation in Children*

Cited by 42 publications

References 18 publications

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children

High-Dose Cyclophosphamide Therapy Associated with Diffuse Alveolar Hemorrhage after Allogeneic Hematopoietic Stem Cell Transplantation

Pulmonary dysfunction in pediatric hematopoietic stem cell transplant patients: Non‐infectious and long‐term complications

Contact Info

Product

Resources

About