Original article: general thoracicDiffuse pulmonary infiltrates after bone marrow transplantation: the role of open lung biopsy
Section snippets
Patients and methods
This study was conducted in the National Taiwan University Hospital, a tertiary-care referral center with 2,000 beds, by review of the medical records and chest images of 341 patients with hematologic diseases who underwent BMT between July 1995 and June 2001. Patients in whom DPI developed were included, with DPI defined as the presence of infiltrates over all four quadrants of the lung fields as seen on chest radiograph. The date of onset was defined as the earliest date when image study
Results
From July 1995 through June 2001, pulmonary infiltrates after BMT occurred in 188 (55.1%) of 341 patients. Diffuse pulmonary infiltrates developed in 68 (19.9%) of the 341 patients, including 63 (23.7%) of 266 allogeneic recipients and 5 (6.67%) of 75 autologous recipients. The clinical characteristics of the 68 patients are listed in Table 1. Relapse of underlying disease before the onset of DPI was proved in 5 (7.4%) of the 68 patients. Sputum collected during the course of DPI was
Comment
Consistent with previous reports 2, 3, our incidence of pulmonary infiltrates after BMT was 55.1% (188 of 341 patients). About one-third of these patients had DPI (68 of 188 patients; 36.2%), with a high mortality rate (50%). The results of open lung biopsy caused major therapeutic change in two-thirds and were associated with clinical improvement in nearly half of the biopsy patients. Patients who underwent open lung biopsy had a much shorter length of mechanical ventilation than patients who
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