[Diffuse alveolar hemorrhage after allogeneic bone marrow transplantation].

Area of Science:

• Hematology
• Pulmonology
• Oncology

Background:

• Allogeneic bone marrow transplantation (BMT) is a curative therapy for hematologic malignancies.
• Complications following BMT can be severe and life-threatening.
• Diffuse alveolar hemorrhage (DAH) is a rare but serious post-BMT complication.

Observation:

• A 34-year-old female with chronic myeloid leukemia developed progressive cough, fever, and hypoxemia 51 days post-BMT.
• Chest imaging revealed worsening pulmonary infiltrates.
• High-resolution CT and bronchoalveolar lavage confirmed diffuse alveolar hemorrhage (DAH).

Findings:

• The patient's DAH was suspected to be secondary to thrombotic microangiopathy.
• Treatment with high-dose methylprednisolone pulse therapy, antibiotics, and haptoglobin led to symptom resolution.
• This case demonstrates a rare remission of DAH post-BMT.

Implications:

• Diffuse alveolar hemorrhage (DAH) post-BMT carries a high mortality rate.
• Steroid therapy may be an effective treatment option for DAH following BMT.
• This case highlights a potential therapeutic strategy for a life-threatening BMT complication.