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Paranasal sinusitis following allogeneic bone marrow transplant
D G Savage1, P Taylor, J Blackwell
1Department of Haematology, Royal Postgraduate Medical School, London, UK.
Bone Marrow Transplantation
|January 1, 1997
Summary
Paranasal sinusitis is common after allogeneic bone marrow transplants (BMT), often occurring within 120 days. Leukopenia and chronic sinusitis are frequent, though fatal complications are rare.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Allogeneic bone marrow transplantation (BMT) can lead to various complications.
- Paranasal sinusitis is a recognized, though not fully understood, post-transplant complication.
Purpose of the Study:
- To identify the clinical features of paranasal sinusitis following allogeneic BMT.
- To explore risk factors and outcomes associated with sinusitis in BMT patients.
Main Methods:
- Retrospective review of 44 patients with paranasal sinusitis post-allogeneic BMT.
- Analysis of clinical data, imaging (radiographs, CT scans), laboratory results, and transplant characteristics.
Main Results:
- Sinusitis commonly presented with characteristic symptoms and signs, often confirmed by imaging (86.4% fluid levels).
- Leukopenia (WBC < 1 x 10^9/L) and neutropenia (< 0.5 x 10^9/L) were frequent; 40.6% had depressed immunoglobulins.
- Graft-versus-host disease (GVHD) was prevalent (94.2% total), and 70.5% received corticosteroids. Microbiological diagnosis was challenging, and 70.5% developed chronic sinusitis. Higher total body irradiation doses correlated with increased sinusitis risk.
Conclusions:
- Paranasal sinusitis is a frequent complication after allogeneic BMT, particularly in patients with leukopenia.
- Microbiological diagnosis is difficult, and progression to chronic sinusitis is common.
- Risk factors include higher radiation doses, while autologous transplants showed a lower incidence.