[Pulmonary complications in haploidentical bone marrow transplantation]

Area of Science:

• Hematology
• Pulmonology
• Infectious Diseases

Context:

• Haploidentical bone marrow transplantation is a life-saving procedure for various hematologic malignancies.
• Pulmonary complications represent a significant cause of morbidity and mortality following transplantation.
• Understanding the temporal patterns and etiologies of these complications is crucial for timely intervention.

Purpose:

• To investigate the occurrence patterns, including onset time and etiology, of pulmonary complications in patients undergoing haploidentical bone marrow transplantation.
• To analyze the management strategies and outcomes associated with different types of pulmonary complications.
• To identify key pathogens and their timing relative to transplantation.

Summary:

• Pulmonary complications occurred in 18 of 70 patients (25.7%) post-haploidentical bone marrow transplantation.
• Pneumonia was the most frequent complication, caused by bacteria (7 cases), fungi (5 cases), and cytomegalovirus (CMV, 4 cases).
• Fungal and CMV pneumonia predominantly occurred 2-3 months post-transplant, while bacterial pneumonia appeared 3-12 months later. Bronchiolitis obliterans organizing pneumonia (BOOP) and idiopathic pneumonia syndrome were diagnosed later. Eight patients died, with fungal pneumonia identified as a major contributor.

Impact:

• This study highlights the high incidence of pulmonary complications after haploidentical bone marrow transplantation.
• It emphasizes the critical role of fungal pneumonia as a leading cause of mortality, necessitating focused diagnostic and therapeutic approaches.
• Findings can inform clinical practice for improved surveillance and management protocols to reduce post-transplant pulmonary complications.