Survey of Academic Pulmonologists, Oncologists, and Infectious Disease Physicians on the Role of Bronchoscopy in Managing Hematopoietic Stem Cell Transplantation Patients With Pulmonary Infiltrates

Wahla, Ali S.; Chatterjee, Arjun; Khan, Irtaza; Conforti, John; Haponik, Edward F.

doi:10.1097/lbr.0000000000000042

Cited by 13 publications

(14 citation statements)

References 3 publications

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“…Provider preference has also been shown to be a barrier to FOB independent of clinical status, 59,60 and delay in diagnosis may have less to do with respiratory status than with physician choice. 61 Based on autopsy studies, PC diagnoses remain elusive before death in many HCT subjects, [12][13][14] suggesting that a 'wait and see' approach to empiric therapy is used commonly. As a result of these differences, rigorous study is difficult and there is limited prospective evidence on which to base decisions regarding optimal timing, modality, yield or impact of FOB on outcomes in these populations.…”

Section: Overview Of Fiberoptic Bronchoscopymentioning

confidence: 99%

Diagnostic Evaluation of Pulmonary Abnormalities in Patients with Hematologic Malignancies and Hematopoietic Cell Transplantation

Harris

Geyer

2017

Clinics in Chest Medicine

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Pulmonary complications (PC) of hematologic malignancies and their treatments are common causes of morbidity and mortality. Early diagnosis is challenging due to host risk factors, clinical instability, and provider preference. Delayed diagnosis impairs targeted treatment and may contribute to poor outcomes. An integrated understanding of clinical risk and radiographic patterns informs a timely approach to diagnosis and treatment. There is little prospective evidence guiding optimal modality and timing of minimally invasive lung sampling; however, a low threshold for diagnostic bronchoscopy during the first 24 to 72 hours after presentation should be a guiding principle in high-risk patients.

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Section: Overview Of Fiberoptic Bronchoscopymentioning

confidence: 99%

Diagnostic Evaluation of Pulmonary Abnormalities in Patients with Hematologic Malignancies and Hematopoietic Cell Transplantation

Harris

Geyer

2017

Clinics in Chest Medicine

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“…Pulmonologists believed that bronchoscopy was less likely to yield a positive result and to change therapy. 63 A broad list of tests can be performed in BAL samples, including direct examination for bacteria and fungi, qualitative and quantitative culture for bacteria, cytology, fluorescent antigen tests (Pneumocystis, Legionella, respiratory viruses), PCR-based techniques (various pathogens), galactomannan, and others.…”

Section: Bronchoalveolar Lavagementioning

confidence: 99%

Distinguishing the Causes of Pulmonary Infiltrates in Patients With Acute Leukemia

Nucci

Nouér

Anaissie

2015

Clinical Lymphoma Myeloma and Leukemia

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“…Although practice patterns vary widely,(75) bronchoscopy with bronchoalveolar lavage (BAL) is the diagnostic tool of choice for obtaining lower respiratory samples from neutropenic cancer patients. (8, 76) BAL is safe for most cancer patients,(8) although traditional culture methods yield a definite pathogen in only 25–51% of cases.…”

Section: Diagnosticsmentioning

confidence: 99%

Pneumonia in the neutropenic cancer patient

Evans

Ost

2015

Current Opinion in Pulmonary Medicine

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Purpose of review Pneumonia is the leading cause of death among neutropenic cancer patients, particularly those with acute leukemia. Even with empiric therapy, case fatality rates of neutropenic pneumonias remain unacceptably high. However, recent advances in the management of neutropenic pneumonia offer hope for improved outcomes in the cancer setting. This review summarizes recent literature regarding the clinical presentation, microbiologic trends, diagnostic advances and therapeutic recommendations for cancer-related neutropenic pneumonia. Recent findings While neutropenic patients acquire pathogens both in community or nosocomial settings, patients’ obligate healthcare exposures result in the frequent identification of multidrug resistant bacterial organisms on conventional culture-based assessment of respiratory secretions. Modern molecular techniques, including expanded use of galactomannan testing, have further facilitated identification of fungal pathogens, allowing for aggressive interventions that appear to improve patient outcomes. Multiple interested societies have issued updated guidelines for antibiotic therapy of suspected neutropenic pneumonia. The benefit of antibiotic medications may be further enhanced by agents that promote host responses to infection. Summary Neutropenic cancer patients have numerous potential causes for pulmonary infiltrates and clinical deterioration, with lower respiratory tract infections among the most deadly. Early clinical suspicion, diagnosis and intervention for neutropenic pneumonia provide cancer patients’ best hope for survival.

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Survey of Academic Pulmonologists, Oncologists, and Infectious Disease Physicians on the Role of Bronchoscopy in Managing Hematopoietic Stem Cell Transplantation Patients With Pulmonary Infiltrates

Cited by 13 publications

References 3 publications

Diagnostic Evaluation of Pulmonary Abnormalities in Patients with Hematologic Malignancies and Hematopoietic Cell Transplantation

Diagnostic Evaluation of Pulmonary Abnormalities in Patients with Hematologic Malignancies and Hematopoietic Cell Transplantation

Distinguishing the Causes of Pulmonary Infiltrates in Patients With Acute Leukemia

Pneumonia in the neutropenic cancer patient

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