Myeloid Leukemias and Lung Involvement

Koh, Tat Tee; Colby, Thomas V.; Müller, Néstor L.

doi:10.1055/s-2005-922034

Cited by 35 publications

(23 citation statements)

References 28 publications

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“…12 These sequelae in adults most often relate to leukemic infiltration of lung or pleural tissue, leukostasis in the setting of systemic hyperleukocytosis, or pneumopathy from tumor lysis. Imaging characteristics of pulmonary involvement in AML vary.…”

Section: Discussionmentioning

confidence: 99%

“…Leukemic infiltration has been associated with a nonspecific chest X-ray pattern that resembles interstitial pneumonia or edema. 12 Chest CT often shows interlobular septal thickening, which may be smooth or nodular. 12 Isolated pulmonary nodules and mass lesions are uncommon.…”

Section: Discussionmentioning

confidence: 99%

“…12 Chest CT often shows interlobular septal thickening, which may be smooth or nodular. 12 Isolated pulmonary nodules and mass lesions are uncommon.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary Presentation of Relapsed Acute Myeloid Leukemia

Hoffman

Gore

Maloney

2014

Journal of Pediatric Hematology/Oncology

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Extramedullary manifestations of acute myeloid leukemia (AML), often referred to as myeloid sarcoma (MS), occur relatively commonly in children with newly diagnosed or relapsed AML and have been associated with certain French-American-British morphologies and gene/chromosomal rearrangements. The most common locations of MS include the skin, orbit, skeleton, central nervous system, skin, and gut. Pulmonary MS is uncommon in adults and is extremely rare in children. We report the case of a 19-year-old man with French-American-British M5 AML, who before bone marrow transplant, presented with fever, hypotension, and respiratory symptoms that were ultimately attributed to pulmonary MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pulmonary Presentation of Relapsed Acute Myeloid Leukemia

Hoffman

Gore

Maloney

2014

Journal of Pediatric Hematology/Oncology

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“…While infectious processes are a major source of pulmonary complications, non-infectious complications are also encountered, including hemorrhage, drug toxicity, veno-occlusive disease, chronic graft-versushost disease and pulmonary leukemic infiltration (PLI) [5][6][7]. Up to 60% of leukemic patients show histological evidence of PLI at autopsy, but only small numbers of patients are correctly diagnosed with PLI while alive [8,9]. This incorrect diagnosis is probably because clinical symptoms and standard radiological findings of PLI are usually non-specific unless patients develop hyperleukocytosis [10].…”

Section: Introductionmentioning

confidence: 99%

Leukemic infiltration of the lung following allogeneic hematopoietic stem cell transplantation

et al. 2008

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Pulmonary leukemic infiltration (PLI) is more common than generally recognized, but accurate antemortem diagnosis with pathological proof is rarely achieved. We describe herein the clinical courses of two patients with PLI following hematopoietic stem cell transplantation (HSCT). One case is a male patient with acute biphenotypic leukemia, and the other is a female patient with myelodysplastic syndrome. In both cases, hyperleukocytosis did not proceed to PLI. Moreover, the former case presented PLI as the initial manifestation of relapsed leukemia and the latter was accompanied with the fungal pneumonia. High-resolution computed tomography (HRCT) of the chest at onset of PLI showed diffuse small nodular lesions along peribronchovascular bundle, and diagnosis of leukemic infiltration was made based on pathological findings obtained from transbronchial lung biopsy. Biopsy specimens further revealed leukemic infiltration along the lymphatic surrounding the peribronchial or perivascluar regions, which corresponded well with HRCT findings. Thus, radiological and pathological corroborating assessment was important to reach the correct diagnosis.

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“…The diagnosis rests on negative findings from extensive tests for the main infectious and noninfectious causes. Leukaemiarelated pulmonary involvement includes pulmonary leukostasis, leukaemic pulmonary infiltrates and lysis pneumopathy [9][10][11][12][13][14][15][16][17][18]. We previously described 20 patients with acute monocytic leukaemia (AML; French-American-British (FAB) classification M5) who presented with either leukaemic infiltrates or leukostasis at the earliest phase of the malignancy [8].…”

mentioning

confidence: 99%

Dexamethasone in patients with acute lung injury from acute monocytic leukaemia

Azoulay¹,

Canet²,

Raffoux³

et al. 2011

European Respiratory Journal

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The use of steroids is not required in myeloid malignancies and remains controversial in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). We sought to evaluate dexamethasone in patients with ALI/ARDS caused by acute monocytic leukaemia (AML FAB-M5) via either leukostasis or leukaemic infiltration.Dexamethasone (10 mg every 6 h until neutropenia) was added to chemotherapy and intensive care unit (ICU) management in 20 consecutive patients between 2005 and 2008, whose data were compared with those from 20 historical controls (1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002). ICU mortality was the primary criterion. We also compared respiratory deterioration rates, need for ventilation and nosocomial infections.17 (85%) patients had hyperleukocytosis, 19 (95%) had leukaemic masses, and all 20 had severe pancytopenia. All patients presented with respiratory symptoms and pulmonary infiltrates prior to AML FAB-M5 diagnosis. Compared with historical controls, dexamethasone-treated patients had a significantly lower ICU mortality rate (20% versus 50%; p50.04) and a trend for less respiratory deterioration (50% versus 80%; p50.07). There were no significant increases in the rates of infections with dexamethasone.In conclusion, in patients with ALI/ARDS related to AML FAB-M5, adding dexamethasone to conventional chemotherapy seemed effective and safe. These results warrant a controlled trial of dexamethasone versus placebo in AML FAB-M5 patients with noninfectious pulmonary infiltrates.

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Myeloid Leukemias and Lung Involvement

Cited by 35 publications

References 28 publications

Pulmonary Presentation of Relapsed Acute Myeloid Leukemia

Pulmonary Presentation of Relapsed Acute Myeloid Leukemia

Leukemic infiltration of the lung following allogeneic hematopoietic stem cell transplantation

Dexamethasone in patients with acute lung injury from acute monocytic leukaemia

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