Diffuse alveolar hemorrhage: an evolving problem?

Weisdorf, DJ

doi:10.1038/sj.leu.2402921

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…In general, emergent medical therapy is the first treatment option in hematologic patients with coagulopathy and diffuse alveolar hemorrhage (18). However, in our results, there was no statistically significant difference in clinical success rate and survival rate between patients with coagulopathy or diffuse alveolar hemorrhagic pattern and other hematologic patients.…”

Section: Discussioncontrasting

confidence: 54%

“…In general, diffuse alveolar hemorrhage is a hemorrhagic syndrome, but it is not associated with hemoptysis because the alveolar epithelium is not just leaking fluid but is perforated sufficiently to leak red cells (18). Thus, aggressive correction of thrombocytopenia and coagulation disturbances may be the first and sufficient treatment option (18). Massive pulmonary hemorrhage that can induce hemoptysis is an uncommon complication of leukemia and is generally attributed to thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

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Bronchial Artery Embolization in the Management of Hemoptysis in Patients with Hematologic Diseases: Feasibility and Short-Term Efficacy

Chun

Lee

et al. 2017

Iran J Radiol

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Background: Patients with hematologic diseases are frequently accompanied by coagulopathy, even a small amount of hemoptysis may worsen clinical outcomes compared to those with the similar severity of injury without coagulopathy. However, a few studies have included various hematologic conditions, and none of them were large series. Objectives: To evaluate the feasibility and short-term efficacy of bronchial artery embolization (BAE) in the management of hemoptysis in patients with hematologic diseases. Methods: This was a retrospective study of 25 patients with hematologic diseases who visited our interventional unit for the management of hemoptysis between 2009 and 2012. The clinical, laboratory, and radiographic data were retrospectively analyzed and we correlated clinical response with the amount of hemoptysis, coagulation condition, radiographic pattern, and bronchial artery hypertrophy. Results: The amount of hemoptysis was trivial in 13 patients (52 %), moderate in ten patients (40%), and massive in two patients

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Bronchial Artery Embolization in the Management of Hemoptysis in Patients with Hematologic Diseases: Feasibility and Short-Term Efficacy

Chun

Lee

et al. 2017

Iran J Radiol

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“…[1][2][3][4]12 Notwithstanding the limitation of small sample size, we observed no benefit with high-dose corticosteroids in hemorrhage occurring after RIC allogeneic HCT. Although all patients with DAH and the majority of patients with IAH in our RIC cohort received high-dose methylprednisolone, 60-day survival from hemorrhage onset was only 28%.…”

Section: Discussionmentioning

confidence: 61%

Alveolar hemorrhage following allogeneic hematopoietic cell transplantation using reduced-intensity conditioning

Majhail

Parks

DeFor

et al. 2006

Bone Marrow Transplant

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Allogeneic hematopoietic cell transplantation (HCT) using reduced-intensity conditioning (RIC) has lower morbidity and mortality compared to transplantation using myeloablative conditioning (MAC). The syndrome of alveolar hemorrhage, a life-threatening pulmonary complication of HCT, has not been well described after RIC HCT. We reviewed prospectively collected data on 206 RIC and 1112 MAC HCT performed between 1995 and 2004 to study the impact of conditioning regimen on the clinical features and outcome of alveolar hemorrhage. Alveolar hemorrhage occurred in 18 RIC HCT recipients (cumulative incidence 8% (95% confidence intervals (CI), 5-11%)) and 85 MAC HCT recipients (cumulative incidence 7% (95% CI, 6-8%), P ¼ 0.56). The clinical presentation of hemorrhage in both cohorts was similar. Survival at 60 days from the onset of hemorrhage was 28% (95% CI, 7-49%) for RIC group compared to 26% (95% CI, 17-35%) after MAC HCT (P ¼ 0.56). Reducing the intensity of preparative regimen does not protect against post transplant alveolar hemorrhage. Alveolar hemorrhage occurring after RIC or MAC HCT has similar incidence, clinical presentation, and associated high mortality.

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“…Infections, cardiac causes including heart failure, toxicity from pretransplant thoracic radiation, chemotherapy, early marrow engraftment, GVHD and cytokines have been postulated to have a role in the pathogenesis of AH after HSCT. [11][12][13][14][15][16][17][18] The reported mortality associated with AH varies from 70 to 100%. [11][12][13][14] Diffuse AH (DAH) was initially described in autologous HSCT recipients and since has been described with equal frequency in both allogeneic and autologous transplant recipients.…”

Section: Introductionmentioning

confidence: 99%