Pulmonary complications after bone marrow transplantation in children: Twenty-four years of experience in a single pediatric center

Griese, Matthias; Rampf, U.; Hofmann, D; Führer, Monika; Reinhardt, D.; Bender‐Götze, Christine

doi:10.1002/1099-0496(200011)30:5<393::aid-ppul5>3.0.co;2-w

Cited by 126 publications

(51 citation statements)

References 17 publications

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“…However, viral infections, encapsulated bacteria, and P jiroveci, in particular, can occur months later. 25 Noninfectious pulmonary complications include diffuse alveolar hemorrhage (DAH), idiopathic pneumonia syndrome (IPS), bronchiolitis obliterans (BO), and BO with organizing pneumonia (BOOP), a manifestation of cGVHD. 26-29 Table 3 describes the presenting symptoms and diagnostic features of noninfectious pulmonary complications after HCT.…”

Section: Discussion Casementioning

confidence: 99%

“…25,27,28,33 Small retrospective studies have shown that the incidence of LONIPCs is 10% to 15% in pediatric patients who have undergone HCT. 25,27,33 Patients at the greatest risk of developing these complications are those who have undergone allogeneic HCT or have severe cGVHD. Bronchiolitis obliterans, especially, is thought to be a form of cGVHD of the lungs and may be seen with other manifestations of cGVHD.…”

Section: Discussion Casementioning

confidence: 99%

“…25,27-29,33,34 Patients with IPS have also been shown to respond to etanercept, a tumor necrosis factor-α blocker. 35,36 Despite treatment, patients with pulmonary complications tend to do significantly worse, with mortality rates approaching 60%, especially in those patients in whom treatment is not started early.…”

Section: Discussion Casementioning

confidence: 99%

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Emergent Complications in the Pediatric Hematopoietic Stem Cell Transplant Patient

Munchel

Chen

Symons

2011

Clinical Pediatric Emergency Medicine

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Hematopoietic cell transplantation is the only potentially curative option for a variety of pediatric malignant and nonmalignant disorders. Despite advances in transplantation biology and immunology as well as in posttransplant management that have contributed to improved survival and decreased transplant-related mortality, hematopoietic cell transplantation does not come without significant risk of complications. When patients who have undergone hematopoietic cell transplantation present to the emergency department, it is important to consider a variety of therapy-related complications to optimize management and outcome. In this article, we use clinical cases to highlight some of the more common emergent complications after hematopoietic cell transplantation.

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Section: Discussion Casementioning

confidence: 99%

Section: Discussion Casementioning

confidence: 99%

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Emergent Complications in the Pediatric Hematopoietic Stem Cell Transplant Patient

Munchel

Chen

Symons

2011

Clinical Pediatric Emergency Medicine

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“…Pulmonary complications develop in 25-60% of HSCT recipients and account for approximately 50% of transplant-related deaths. [1][2][3] Pulmonary complications after HSCT include infectious or noninfectious causes, defined as early or late, according to the time of onset after transplant. Idiopathic pneumonia syndrome describes a clinical entity of diffuse lung injury that occurs around 90 days post-transplant and for which no infectious cause can be identified.…”

Section: Introductionmentioning

confidence: 99%

“…The P aO 2 /F IO 2 was 209 mm Hg and the Murray score was 1.5 on ICU day 10. On ICU day 18, despite an increase in peak inspiratory pressure (PIP) up to 26 cm H 2 O, the worsening hypercapnia was persistent (pH 7.233, P aCO 2 71.5 mm Hg, HCO 3 Ϫ 29.5 mmol/L, P aO 2 /F IO 2 131 mm Hg), with a Murray score of 3. The ventilator mode was pressure regulated volume control, tidal volume was 6.2 mL/ kg, PEEP was 14 cm H 2 O, and F IO 2 was 0.8.…”

Section: Introductionmentioning

confidence: 99%

Successful Use of Extracorporeal Membrane Oxygenation in a Hematopoietic Stem Cell Transplant Patient With Idiopathic Pneumonia Syndrome

Liao¹,

Tsai²,

Chiu

2013

Respir Care

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We report the case of an adult patient with idiopathic pneumonia syndrome following allogeneic hematopoietic stem cell transplantation, which was successfully managed with venovenous extracorporeal membrane oxygenation (ECMO) and immunosuppressive therapy. A 30-year-old man with precursor B cell acute lymphocytic leukemia had received chemotherapy 10 years previously, with complete remission. He underwent allogeneic hematopoietic stem cell transplantation 4 months prior to enrollment, owing to leukemia relapse. One hundred thirty days post-transplant the patient developed shortness of breath, nonproductive cough, and low-grade fever for 1 week. He subsequently developed acute hypercapnic and hypoxic respiratory failure that was unresponsive to conventional medical therapy. He was successfully managed with venovenous ECMO for 19 days, with complete resolution of his respiratory symptoms. Thus, judicious use of ECMO as a bridge before steroid and other conventional therapy take effect in patients with isolated respiratory failure appears justified.

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Bronchoalveolar lavage protein patterns in children with malignancies, immunosuppression, fever and pulmonary infiltrates

Neumann¹,

Bredow²,

Ratjen³

et al. 2002

Proteomics

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Severe respiratory infections are a major cause of morbidity and mortality in children receiving immunosuppressive therapy for malignancies. The goal of this study was to assess the major changes in the protein patterns in these children. Bronchoalveolar lavage (BAL) fluids of seven control children and of ten children with malignancies and fever not responding to broad spectrum antibiotic treatment was separated by horizontal two-dimensional sodium dodecyl sulfate-polyacrylamide gel electrophoresis in the isoelectric point range 3-9. We observed a large increase of alpha(1)-antitrypsin (p = 0.0004) and decreases of the immunoglobulin (Ig) binding factor, transthyretin and cystatin S. Significant changes occurred also in the small acidic proteins. The relative abundance of the IgG heavy and light chains may hinder the separation and identification of many minor protein spots located in the basic area of the gel, suggesting that their removal during sample preparation may be warranted. This study demonstrated significant alterations in BAL fluid proteome in immunosuppressed children with persistent fever and pulmonary infiltrates. Future target regions of interest were identified. Sample prefractionation and the selection of suitable narrow isoelectric point ranges will be necessary for optimized detection and separating conditions.

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Pulmonary complications after bone marrow transplantation in children: Twenty-four years of experience in a single pediatric center

Cited by 126 publications

References 17 publications

Emergent Complications in the Pediatric Hematopoietic Stem Cell Transplant Patient

Emergent Complications in the Pediatric Hematopoietic Stem Cell Transplant Patient

Successful Use of Extracorporeal Membrane Oxygenation in a Hematopoietic Stem Cell Transplant Patient With Idiopathic Pneumonia Syndrome

Bronchoalveolar lavage protein patterns in children with malignancies, immunosuppression, fever and pulmonary infiltrates

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