Pulmonary complications in haematopoietic stem cell transplant patients – a single-centre experience

Ref ID: 18562

Author:

T. Tan, M. Wu, L. Chiou

Author address:

Koo Foundation Sun Yat-Sen Cancer Center (Taipei, TW)

Full conference title:

Annual Meeting of the EBMT, 38th

Abstract:

Background: Pulmonary complications are the most probable
causes of life-threatening episodes in hematopoietic stem cell
transplantation patients. There are a variety of causes including infectious and non-infectious etiologies to result in those
events. We analyzed the experience of our institution to treat
such kind of patients.
Methods: For all patients after the treatment of hematopoietic
stem cell patients once developed respiratory symptoms, we
performed plain fi lm X ray and CT scan of lungs and prepared
bronchoscopic examination including transbronchoscopic biopsy and bronchioloalveolar lavarge, and transcutaneous core
needle biopsy of lung or thoracoscopic resection of lung tissue
to check cytology, histopathology, and sent for bacterial, fungal, and tuberculous cultures and special stains for bacteria,
fungus, tuberculosis, CMV, HSV, PJP, and PCR for CMV, HSV,
PJP, RSV, infl uenza, parainfl uenza, adenovirus, and VZV.
Results: Between March 2001 and November 2011, we have
181 patients undergoing hematopoietic stem cell transplantation at our institution including 108 patients received allotransplant and 73 autotransplant. Forty-fi ve episodes of pulmonary
complications occurred in allogeneic stem cell transplant
except one invasive pulmonary aspergillosis occurred in an
[P637]S201
autotransplant patient (24.8% in all patients or 40.7% in allotransplant patients). For allogeneic stem cell transplantation
patients, the incidence of the diverse etiology of pulmonary
complications are as follows: CMV pneumonia 11.1%, chronic
GVHD or bronchiolitis obliterans 7.4%, capillary leak or engraftment syndrome 5.6%, fungal pneumonia 3.7%, tuberculous
pneumonia 3.7%, unspecifi ed pneumonia 3.7%, pulmonary
hemorrhage 2.8%, RSV pneumonia 1.9%, HSV pneumonia
0.9%, and leukemic infi ltrate 0.9%. Moreover, the mortality rate
of these pulmonary complications were up to 46.7% (21 patients in these 45 episodes).
Conclusions: Post-transplant pulmonary complication is a lifethreatening event and the two most probable causes are CMV
pneumonia and chronic GVHD related bronchiolitis obliterans.
It is crucial to make early diagnosis and to deliver the most
appropriate treatment for these patients.

Abstract Number: P638

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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