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Related Experiment Videos

[Pulmonary complications after bone marrow transplantation]

M Giacchino1, A Busca, R Miniero

  • 1Istituto Discipline Pediatriche, Clinica Pediatrica II, Torino.

Minerva Pediatrica
|April 1, 1993
PubMed
Summary

Bone marrow transplantation (BMT) patients face significant pulmonary risks, including bacterial, fungal, and viral pneumonitis. Early diagnosis and management are crucial for improving outcomes in these vulnerable individuals.

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Bone marrow transplantation·2017

Area of Science:

  • Hematology
  • Oncology
  • Infectious Diseases

Context:

  • Pulmonary complications are frequent in bone marrow transplantation (BMT) recipients, affecting 10-50% of patients.
  • Bacterial pneumonia is common within 6 months post-BMT, linked to neutropenia and graft-versus-host disease (GVHD).
  • Fungal infections (Candida, Aspergillus) have high mortality (80%) and are associated with prolonged neutropenia and immunosuppression.

Purpose:

  • To review the spectrum of pulmonary complications following BMT.
  • To identify key risk factors and pathogens associated with post-BMT lung injury.
  • To emphasize the need for prompt diagnosis and management of pulmonary issues.

Summary:

  • Interstitial pneumonitis occurs in 10-40% of BMT patients, often caused by herpes viruses like cytomegalovirus (CMV).

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  • In up to 60% of cases, the causative agent remains unidentified, potentially due to drug or radiation toxicity.
  • GVHD and its treatments increase susceptibility to lung infections, with GVHD possibly directly affecting lung epithelium.
  • Impact:

    • Improved understanding of pulmonary toxicity post-BMT can guide preventative strategies.
    • Diagnostic procedures like bronchoalveolar lavage are essential for targeted treatment.
    • Reduced incidence of interstitial pneumonitis has been achieved through radiation techniques like lung shielding and dose fractionation.