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Thoracic complications related to bone marrow transplantation
A A Floreani1, J H Sisson, J Gurney
1Section of Pulmonary and Critical Care Medicine, University of Nebraska Medical Center, Nebraska Health Systems, Omaha, USA.
Chest Surgery Clinics of North America
|March 18, 1999
Summary
Respiratory complications post-bone marrow transplant (BMT) remain a significant concern. Advances in diagnostics and treatments, including CMV-negative products and early detection of infections, are improving patient outcomes and survival rates.
Area of Science:
- Hematology
- Oncology
- Infectious Diseases
Background:
- Respiratory complications are a major cause of morbidity and mortality after bone marrow transplantation (BMT).
- Despite progress, these complications remain frequent challenges in BMT patient care.
Purpose of the Study:
- To review current strategies for diagnosing and managing respiratory complications following BMT.
- To highlight advancements in reducing the incidence and improving the outcomes of these complications.
Main Methods:
- Review of established and emerging diagnostic techniques for respiratory infections post-BMT.
- Discussion of prophylactic and therapeutic interventions for common respiratory complications.
- Analysis of factors influencing survival, including diagnostic timing and treatment approaches.
Main Results:
- Use of cytomegalovirus (CMV)-negative marrow and blood products, surveillance bronchoscopies, and antiviral prophylaxis have decreased CMV pneumonia incidence.
- DNA amplification techniques enable earlier detection of viral respiratory infections.
- Early diagnosis of invasive aspergillosis improves survival through lung resection and antifungal therapy.
Conclusions:
- Early detection and targeted therapies are crucial for managing respiratory complications after BMT.
- Consideration of patient respiratory status is vital when planning invasive procedures like open lung biopsy.