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Bilateral interstitial pneumonia in acute lymphoblastic leukemia.

R Iyer, Y Ravindranath, R Kulkarni

    American Journal of Hematology
    |January 1, 1976
    PubMed
    Summary
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    Bilateral interstitial pneumonia (BIP) affects over 22% of children with acute lymphoblastic leukemia (ALL), often occurring early in treatment. Viral infections are the likely cause, with a 10.3% mortality rate observed in this study.

    Area of Science:

    • Pediatric Oncology
    • Pulmonology
    • Infectious Diseases

    Background:

    • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
    • Bilateral interstitial pneumonia (BIP) is a serious complication observed in ALL patients.
    • Understanding the incidence and etiology of BIP in ALL is crucial for patient management.

    Purpose of the Study:

    • To determine the incidence of BIP in children diagnosed with ALL.
    • To identify potential etiologic factors contributing to BIP in this patient population.
    • To assess the clinical outcomes and mortality associated with BIP in ALL.

    Main Methods:

    • Retrospective review of medical records for 148 children with ALL.
    • Analysis of 34 cases diagnosed with bilateral interstitial pneumonia (BIP).

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  • Review of laboratory data, histopathology from lung biopsies and autopsies.

    • Main Results:

    • The incidence of BIP in ALL patients was 22.9% at the Children's Hospital of Michigan.
    • Most BIP episodes (82%) occurred within the first six months of ALL diagnosis, predominantly in the first three months.
    • Laboratory and histopathologic findings suggested a viral etiology; Pneumocystis carinii infection was rare, and methotrexate hypersensitivity was not supported.

    Conclusions:

    • Bilateral interstitial pneumonia (BIP) is a significant complication in pediatric acute lymphoblastic leukemia (ALL) with a notable incidence (22.9%) and mortality (10.3%).
    • The majority of BIP cases occur early in the course of ALL treatment, suggesting a link to the disease or its initial management.
    • Viral infections are implicated as the primary cause of BIP in ALL patients, necessitating further investigation into specific pathogens and preventative strategies.