Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center
Bone marrow transplantation (BMT) is used to treat various malignant and nonmalignant disorders. Pulmonary complications are some of the most common causes of mortality in BMT recipients. Poor general health and bleeding tendency frequently preclude the use of definitive diagnostic tests, such as op...
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| Veröffentlicht in: | Archives of pathology & laboratory medicine (1976) 2005-03, Vol.129 (3), p.366-371 |
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| container_title | Archives of pathology & laboratory medicine (1976) |
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| creator | Roychowdhury, Monika Pambuccian, Stefan E Aslan, Deniz L Jessurun, Jose Rose, Alan G Manivel, J Carlos Gulbahce, H Evin |
| description | Bone marrow transplantation (BMT) is used to treat various malignant and nonmalignant disorders. Pulmonary complications are some of the most common causes of mortality in BMT recipients. Poor general health and bleeding tendency frequently preclude the use of definitive diagnostic tests, such as open lung biopsy, in these patients.
To identify pulmonary complications after BMT and their role as the cause of death (COD).
The autopsy and bronchoalveolar lavage (BAL) slides and microbiology studies of BMT recipients from a 7-year period were reviewed.
Pulmonary complications were identified in 40 (80%) of the 50 cases. The most common complications were diffuse alveolar damage (DAD) and diffuse alveolar hemorrhage (DAH). Pulmonary complications were the sole or 1 of multiple CODs in 37 cases (74%). All complications were more common in allogeneic BMT recipients. In 19 (51%) of the 37 cases in which pulmonary complications contributed to the death, cultures were negative. Both DAD and DAH, complications commonly reported in the early post-BMT period, were seen more than 100 days after BMT in 33% and 12% of cases, respectively. Five (83%) of 6 cases of invasive pulmonary aspergillosis diagnosed at autopsy were negative for fungi ante mortem (by BAL and cultures).
Pulmonary complications are a significant COD in BMT recipients, many of which, especially the fungal infections, are difficult to diagnose ante mortem. The etiology of DAD and DAH is likely to be multifactorial, and these complications are not limited to the early posttransplantation period. Autopsy examination is important in determining the COD in BMT recipients. |
| doi_str_mv | 10.5858/2005-129-366-pcabmt |
| format | Article |
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To identify pulmonary complications after BMT and their role as the cause of death (COD).
The autopsy and bronchoalveolar lavage (BAL) slides and microbiology studies of BMT recipients from a 7-year period were reviewed.
Pulmonary complications were identified in 40 (80%) of the 50 cases. The most common complications were diffuse alveolar damage (DAD) and diffuse alveolar hemorrhage (DAH). Pulmonary complications were the sole or 1 of multiple CODs in 37 cases (74%). All complications were more common in allogeneic BMT recipients. In 19 (51%) of the 37 cases in which pulmonary complications contributed to the death, cultures were negative. Both DAD and DAH, complications commonly reported in the early post-BMT period, were seen more than 100 days after BMT in 33% and 12% of cases, respectively. Five (83%) of 6 cases of invasive pulmonary aspergillosis diagnosed at autopsy were negative for fungi ante mortem (by BAL and cultures).
Pulmonary complications are a significant COD in BMT recipients, many of which, especially the fungal infections, are difficult to diagnose ante mortem. The etiology of DAD and DAH is likely to be multifactorial, and these complications are not limited to the early posttransplantation period. Autopsy examination is important in determining the COD in BMT recipients.</description><identifier>ISSN: 0003-9985</identifier><identifier>EISSN: 1543-2165</identifier><identifier>DOI: 10.5858/2005-129-366-pcabmt</identifier><identifier>PMID: 15737032</identifier><identifier>CODEN: APLMAS</identifier><language>eng</language><publisher>United States: College of American Pathologists</publisher><subject>Adolescent ; Adult ; Aged ; Anemia ; Aspergillosis - diagnosis ; Aspergillosis - mortality ; Aspergillus - isolation & purification ; Autopsies ; Autopsy ; Biopsy ; Blood clots ; Bone marrow ; Bone Marrow Transplantation - adverse effects ; Bone Marrow Transplantation - mortality ; Bronchoalveolar Lavage Fluid - microbiology ; Child ; Child, Preschool ; Cytomegalovirus ; Diagnostic tests ; Disease ; Female ; Hemorrhage ; Hemorrhage - etiology ; Hemorrhage - mortality ; Humans ; Infant ; Lavage ; Leukemia ; Lung Diseases - etiology ; Lung Diseases - microbiology ; Lung Diseases - mortality ; Lung Diseases, Fungal - diagnosis ; Lung Diseases, Fungal - mortality ; Male ; Middle Aged ; Mortality ; Pulmonary Alveoli - pathology ; Stem cell transplantation ; Transplantation, Homologous - mortality</subject><ispartof>Archives of pathology & laboratory medicine (1976), 2005-03, Vol.129 (3), p.366-371</ispartof><rights>Copyright College of American Pathologists Mar 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-18a62ce2ac0a9274904f90271d16abc77185baf77eac1500ded63b27d684fbf83</citedby><cites>FETCH-LOGICAL-c396t-18a62ce2ac0a9274904f90271d16abc77185baf77eac1500ded63b27d684fbf83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15737032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roychowdhury, Monika</creatorcontrib><creatorcontrib>Pambuccian, Stefan E</creatorcontrib><creatorcontrib>Aslan, Deniz L</creatorcontrib><creatorcontrib>Jessurun, Jose</creatorcontrib><creatorcontrib>Rose, Alan G</creatorcontrib><creatorcontrib>Manivel, J Carlos</creatorcontrib><creatorcontrib>Gulbahce, H Evin</creatorcontrib><title>Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center</title><title>Archives of pathology & laboratory medicine (1976)</title><addtitle>Arch Pathol Lab Med</addtitle><description>Bone marrow transplantation (BMT) is used to treat various malignant and nonmalignant disorders. Pulmonary complications are some of the most common causes of mortality in BMT recipients. Poor general health and bleeding tendency frequently preclude the use of definitive diagnostic tests, such as open lung biopsy, in these patients.
To identify pulmonary complications after BMT and their role as the cause of death (COD).
The autopsy and bronchoalveolar lavage (BAL) slides and microbiology studies of BMT recipients from a 7-year period were reviewed.
Pulmonary complications were identified in 40 (80%) of the 50 cases. The most common complications were diffuse alveolar damage (DAD) and diffuse alveolar hemorrhage (DAH). Pulmonary complications were the sole or 1 of multiple CODs in 37 cases (74%). All complications were more common in allogeneic BMT recipients. In 19 (51%) of the 37 cases in which pulmonary complications contributed to the death, cultures were negative. Both DAD and DAH, complications commonly reported in the early post-BMT period, were seen more than 100 days after BMT in 33% and 12% of cases, respectively. Five (83%) of 6 cases of invasive pulmonary aspergillosis diagnosed at autopsy were negative for fungi ante mortem (by BAL and cultures).
Pulmonary complications are a significant COD in BMT recipients, many of which, especially the fungal infections, are difficult to diagnose ante mortem. The etiology of DAD and DAH is likely to be multifactorial, and these complications are not limited to the early posttransplantation period. Autopsy examination is important in determining the COD in BMT recipients.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anemia</subject><subject>Aspergillosis - diagnosis</subject><subject>Aspergillosis - mortality</subject><subject>Aspergillus - isolation & purification</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Biopsy</subject><subject>Blood clots</subject><subject>Bone marrow</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>Bone Marrow Transplantation - mortality</subject><subject>Bronchoalveolar Lavage Fluid - microbiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cytomegalovirus</subject><subject>Diagnostic tests</subject><subject>Disease</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Hemorrhage - etiology</subject><subject>Hemorrhage - mortality</subject><subject>Humans</subject><subject>Infant</subject><subject>Lavage</subject><subject>Leukemia</subject><subject>Lung Diseases - etiology</subject><subject>Lung Diseases - microbiology</subject><subject>Lung Diseases - mortality</subject><subject>Lung Diseases, Fungal - diagnosis</subject><subject>Lung Diseases, Fungal - mortality</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Pulmonary Alveoli - pathology</subject><subject>Stem cell transplantation</subject><subject>Transplantation, Homologous - mortality</subject><issn>0003-9985</issn><issn>1543-2165</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpdkUtLxDAUhYMoOo7-AkGCC3fVPJqkcaeDL1CcxbgOt2kqI21TkxSZf2_UAcHV5cJ3DodzEDqh5EJUorpkhIiCMl1wKYvRQt2nHTSjouQFo1LsohkhhBdaV-IAHcb4nl_NGN1HB1QorghnM-SXU9f7AcIGW9-P3dpCWvshYmiTC7j2g8M9hOA_cQowxLGDIf0gVxgGDFPyY9zgmKZmg9vgewy4g_Dm_uPYuiE7HqG9Frrojrd3jl7vbleLh-Lp5f5xcf1UWK5lKmgFklnHwBLQTJWalK0mTNGGSqitUrQSNbRKObBUENK4RvKaqUZWZVu3FZ-j81_fMfiPycVk-nW0rst5nJ-ikapUVMoyg2f_wHc_hSFnM4xSrTTLXc0R_4Vs8DEG15oxrHMtG0OJ-R7DfI9h8hgmj2GWi-ub51VWnW6tp7p3zZ9m2z7_AvbMiLI</recordid><startdate>200503</startdate><enddate>200503</enddate><creator>Roychowdhury, Monika</creator><creator>Pambuccian, Stefan E</creator><creator>Aslan, Deniz L</creator><creator>Jessurun, Jose</creator><creator>Rose, Alan G</creator><creator>Manivel, J Carlos</creator><creator>Gulbahce, H Evin</creator><general>College of American Pathologists</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>200503</creationdate><title>Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center</title><author>Roychowdhury, Monika ; Pambuccian, Stefan E ; Aslan, Deniz L ; Jessurun, Jose ; Rose, Alan G ; Manivel, J Carlos ; Gulbahce, H Evin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-18a62ce2ac0a9274904f90271d16abc77185baf77eac1500ded63b27d684fbf83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anemia</topic><topic>Aspergillosis - diagnosis</topic><topic>Aspergillosis - mortality</topic><topic>Aspergillus - isolation & purification</topic><topic>Autopsies</topic><topic>Autopsy</topic><topic>Biopsy</topic><topic>Blood clots</topic><topic>Bone marrow</topic><topic>Bone Marrow Transplantation - adverse effects</topic><topic>Bone Marrow Transplantation - mortality</topic><topic>Bronchoalveolar Lavage Fluid - microbiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cytomegalovirus</topic><topic>Diagnostic tests</topic><topic>Disease</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Hemorrhage - etiology</topic><topic>Hemorrhage - mortality</topic><topic>Humans</topic><topic>Infant</topic><topic>Lavage</topic><topic>Leukemia</topic><topic>Lung Diseases - etiology</topic><topic>Lung Diseases - microbiology</topic><topic>Lung Diseases - mortality</topic><topic>Lung Diseases, Fungal - diagnosis</topic><topic>Lung Diseases, Fungal - mortality</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Pulmonary Alveoli - pathology</topic><topic>Stem cell transplantation</topic><topic>Transplantation, Homologous - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Roychowdhury, Monika</creatorcontrib><creatorcontrib>Pambuccian, Stefan E</creatorcontrib><creatorcontrib>Aslan, Deniz L</creatorcontrib><creatorcontrib>Jessurun, Jose</creatorcontrib><creatorcontrib>Rose, Alan G</creatorcontrib><creatorcontrib>Manivel, J Carlos</creatorcontrib><creatorcontrib>Gulbahce, H Evin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roychowdhury, Monika</au><au>Pambuccian, Stefan E</au><au>Aslan, Deniz L</au><au>Jessurun, Jose</au><au>Rose, Alan G</au><au>Manivel, J Carlos</au><au>Gulbahce, H Evin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center</atitle><jtitle>Archives of pathology & laboratory medicine (1976)</jtitle><addtitle>Arch Pathol Lab Med</addtitle><date>2005-03</date><risdate>2005</risdate><volume>129</volume><issue>3</issue><spage>366</spage><epage>371</epage><pages>366-371</pages><issn>0003-9985</issn><eissn>1543-2165</eissn><coden>APLMAS</coden><abstract>Bone marrow transplantation (BMT) is used to treat various malignant and nonmalignant disorders. Pulmonary complications are some of the most common causes of mortality in BMT recipients. Poor general health and bleeding tendency frequently preclude the use of definitive diagnostic tests, such as open lung biopsy, in these patients.
To identify pulmonary complications after BMT and their role as the cause of death (COD).
The autopsy and bronchoalveolar lavage (BAL) slides and microbiology studies of BMT recipients from a 7-year period were reviewed.
Pulmonary complications were identified in 40 (80%) of the 50 cases. The most common complications were diffuse alveolar damage (DAD) and diffuse alveolar hemorrhage (DAH). Pulmonary complications were the sole or 1 of multiple CODs in 37 cases (74%). All complications were more common in allogeneic BMT recipients. In 19 (51%) of the 37 cases in which pulmonary complications contributed to the death, cultures were negative. Both DAD and DAH, complications commonly reported in the early post-BMT period, were seen more than 100 days after BMT in 33% and 12% of cases, respectively. Five (83%) of 6 cases of invasive pulmonary aspergillosis diagnosed at autopsy were negative for fungi ante mortem (by BAL and cultures).
Pulmonary complications are a significant COD in BMT recipients, many of which, especially the fungal infections, are difficult to diagnose ante mortem. The etiology of DAD and DAH is likely to be multifactorial, and these complications are not limited to the early posttransplantation period. Autopsy examination is important in determining the COD in BMT recipients.</abstract><cop>United States</cop><pub>College of American Pathologists</pub><pmid>15737032</pmid><doi>10.5858/2005-129-366-pcabmt</doi><tpages>6</tpages></addata></record> |
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| ispartof | Archives of pathology & laboratory medicine (1976), 2005-03, Vol.129 (3), p.366-371 |
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| source | MEDLINE; Allen Press Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adolescent Adult Aged Anemia Aspergillosis - diagnosis Aspergillosis - mortality Aspergillus - isolation & purification Autopsies Autopsy Biopsy Blood clots Bone marrow Bone Marrow Transplantation - adverse effects Bone Marrow Transplantation - mortality Bronchoalveolar Lavage Fluid - microbiology Child Child, Preschool Cytomegalovirus Diagnostic tests Disease Female Hemorrhage Hemorrhage - etiology Hemorrhage - mortality Humans Infant Lavage Leukemia Lung Diseases - etiology Lung Diseases - microbiology Lung Diseases - mortality Lung Diseases, Fungal - diagnosis Lung Diseases, Fungal - mortality Male Middle Aged Mortality Pulmonary Alveoli - pathology Stem cell transplantation Transplantation, Homologous - mortality |
| title | Pulmonary complications after bone marrow transplantation: an autopsy study from a large transplantation center |
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