Rational approach to pulmonary infiltrates in leukemia and transplantation

At present, a number of invasive diagnostic techniques can be used to diagnose the cause of lung infiltrates in patients with hematologic malignancies or hematopoietic stem cell transplantation recipients. Bronchoscopy with measurement of biomarkers in the bronchoalveolar lavage (BAL) will most likely become the preferred method to diagnose infectious causes of pulmonary infiltrates. However, there is no uniform approach regarding the technical parameters of the lavage procedure in cancer patients. Diagnostic protocols vary by region, center, and the expertise of the staff. This mini review discusses the issues surrounding diffuse pulmonary infiltrates and provides some recommendations to deal with these issues.