Percutaneous Lung Biopsy in Immunocompromised Pediatric Patients

Cleveland, Heather; Chau, Alex; Jeng, Zachary; Gardner, Gregory; Yoo, Raphael; Zhang, Wei; Hernandez, J. Alberto

doi:10.1016/j.jvir.2019.07.016

Cited by 8 publications

(9 citation statements)

References 17 publications

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“…Platelet transfusion goals and other coagulation parameters for common operative procedures other than line placements, including tumor biopsies and resections, should be discussed with the surgical or interventional radiology team and anesthesia team 15. Lung biopsy in immunocompromised patients carries higher risk of complications and mortality due to bleeding 16. While there is no platelet threshold required to undergo anesthesia for bone marrow biopsy and bone marrow aspirate alone, a minimal platelet level of 10,000/μL should be considered in this patient population.…”

Section: Results and Recommendationsmentioning

confidence: 99%

“…15 Lung biopsy in immunocompromised patients carries higher risk of complications and mortality due to bleeding. 16 While there is no platelet threshold required to undergo anesthesia for bone marrow biopsy and bone marrow aspirate alone, a minimal platelet level of 10,000/μL should be considered in this patient population. There exists some variability in practice regarding the platelet count required solely for anesthesia itself for scans and other noninvasive events.…”

Section: What Preanesthesia and Preprocedural Laboratory Testing Is R...mentioning

confidence: 99%

See 1 more Smart Citation

Guideline for Children With Cancer Receiving General Anesthesia for Procedures and Imaging

Devine

Diorio²,

Richman³

et al. 2022

Journal of Pediatric Hematology/Oncology

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Children with cancer and those undergoing hematopoietic stem cell transplantation frequently require anesthesia for imaging as well as diagnostic and therapeutic procedures from diagnosis through follow-up. Due to their underlying disease and side effects of chemotherapy and radiation, they are at risk for complications during this time, yet no published guideline exists for preanesthesia preparation. A comprehensive literature review served as the basis for discussions among our multidisciplinary panel of oncologists, anesthesiologists, nurse practitioners, clinical pharmacists, pediatric psychologists, surgeons and child life specialists at the Children’s Hospital of Philadelphia. Due to limited literature available, this panel created an expert consensus guideline addressing anesthesia preparation for this population.

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Section: Results and Recommendationsmentioning

confidence: 99%

Section: What Preanesthesia and Preprocedural Laboratory Testing Is R...mentioning

confidence: 99%

Guideline for Children With Cancer Receiving General Anesthesia for Procedures and Imaging

Devine

Diorio²,

Richman³

et al. 2022

Journal of Pediatric Hematology/Oncology

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show abstract

“…It can be performed by ultrasound if the lesion or abnormality is in the lung periphery or by CT guidance. Recently, Cleveland et al reported the largest cohort of 68 immunocompromised pediatric patients (50 HCT) who underwent 73 percutaneous lung biopsies ( 48 ). Percutaneous lung biopsy was performed under either CT guidance (37%) or US guidance (56%) or both (7%), mostly for lesions that are pleural spaced (84%).…”

Section: Lung Biopsymentioning

confidence: 99%

Pulmonary Complications in Children Following Hematopoietic Cell Transplantation: A Case Report and Review of the Diagnostic Approach

et al. 2021

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Pulmonary complications are common in children following hematopoietic cell transplantation (HCT) and contribute to their morbidity and mortality. Early diagnosis is essential for management and prevention of progression of lung injury and damage. In many cases, diagnosis can be challenging and may require diagnostic imaging and more invasive testing such as bronchoscopy and lung biopsy. We report the case of a 12-year-old girl who developed recurrent episodes of acute respiratory failure requiring intensive care unit admission in the post-HCT phase and describe the diagnostic and multidisciplinary approach for her management. In addition, we review the diagnostic approach of pulmonary complications post-HCT and highlight the utility and risks of bronchoscopy and lung biopsy in these children.

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“…Once LBx becomes well integrated into the clinical practice, it could replace solid biopsy for those cases requiring multiple draws at close range over time, or for patients that are unfit for undergoing an invasive solid biopsy procedure. Patients unfit for a solid biopsy are, for example, immunosuppressed subjects, who may suffer more easily from procedure-related complications, thus contributing to lower diagnostic power and higher mortality rates [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Liquid Biopsy in Cancer: Focus on Lymphoproliferative Disorders

Savino

Rigali

Giustini

et al. 2022

Cancers

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Within the context of precision medicine, the scientific community is giving particular attention to early diagnosis and intervention, guided by non-invasive methodologies. Liquid biopsy (LBx) is a recent laboratory approach consisting of a non-invasive blood draw, which allows the detection of information about potential prognostic factors, or markers to be used for diagnostic purposes; it might also allow the clinician to establish a treatment regimen and predict a patient’s response. Since the discovery of circulating tumor cells (CTCs) in the nineteenth century, the possibility of integrating LBx into clinical practice has been explored, primarily because of its safeness and easy execution: indeed, compared to solid biopsy, sampling-related risks are less of a concern, and the quickness and repeatability of the process could help confirm a prompt diagnosis or to further corroborate the existence of a metastatic spreading of the disease. LBx’s usefulness has been consolidated in a narrow range of oncological settings, first of all, non-small cell lung carcinoma (NSCLC), and it is now gradually being assessed also in lymphoproliferative diseases, such as acute lymphocytic leukemia (ALL), B-cell lymphomas, and multiple myeloma. The present review aims to summarize LBx's overall characteristics (such as its advantages and flaws, collection and analysis methodologies, indications, and targets of the test), and to highlight the applications of this technique within the specific field of B-cell malignancies. The perspectives on how such a simple and convenient technique could improve hemato-oncological clinical practice are broadly encouraging, yet far from a complete integration in routine clinical settings.

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Percutaneous Lung Biopsy in Immunocompromised Pediatric Patients

Cited by 8 publications

References 17 publications

Guideline for Children With Cancer Receiving General Anesthesia for Procedures and Imaging

Guideline for Children With Cancer Receiving General Anesthesia for Procedures and Imaging

Pulmonary Complications in Children Following Hematopoietic Cell Transplantation: A Case Report and Review of the Diagnostic Approach

Liquid Biopsy in Cancer: Focus on Lymphoproliferative Disorders

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