Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Complications

Yield of bronchoalveolar lavage in ventilated and non-ventilated children after bone marrow transplantation

Abstract

A study was undertaken to retrospectively evaluate the yield of bronchoalveolar lavage (BAL) in a single-institution series of children after bone marrow transplantation (BMT) and to compare the yield of BAL between the ventilated and nonventilated patients. We reviewed charts of 52 consecutive children after BMT who underwent BAL. Thirty patients (41 BALs) were nonventilated (group 1) and 33 patients (45 BALs) were ventilated for respiratory failure (group 2). Eleven patients were included in both groups. BAL was performed a median of 255 and 28.5 days after BMT in groups 1 and 2, respectively (Pā€‰<ā€‰0.001). Group 1: 17 pathogens were isolated from 13 BALs; a single pathogen from 10 BALs. Group 2: 15 pathogens were isolated from 14 BALs (31.1% positive). Viruses were isolated from 13 BALs in group 2. A severe complication of BAL occurred in only one patient from group 1 (1.1%). Open lung biopsies were performed in one patient in group 1 and eight patients in group 2. The histological findings correlated with the BAL findings in 66.7%. In conclusion, there was no difference in the yield of BAL between the groups. Therapy was changed in one third of the patients dictated by the BAL findings. The risk of severe complications was relatively low. A good correlation between open lung biopsy (OLB) and BAL was found. Bone Marrow Transplantation (2001) 27, 191ā€“194.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Quabeck K . The lung as a critical organ in marrow transplantation Bone Marrow Transplant 1994 14: (Suppl.) S19ā€“S28

    PubMedĀ  Google ScholarĀ 

  2. Soubani AO, Miller KB, Hassoun PM . Pulmonary complications of bone marrow transplantation Chest 1996 109: 1066ā€“1077

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  3. Gentile G, Miccozi A, Girmenia C et al. Pneumonia in allogeneic bone marrow recipients: a retrospective study Chest 1993 104: 371ā€“373

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  4. Dunagan DP, Baker AM, Hurd DD, Haponik EF . Bronchoscopic evaluation of pulmonary infiltrates following bone marrow transplantation Chest 1997 111: 135ā€“141

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  5. Chan CK, Hyland RH, Hutcheon MA . Pulmonary complications after bone marrow transplant Clin Chest Med 1990 11: 323ā€“332

    CASĀ  PubMedĀ  Google ScholarĀ 

  6. Winer-Muram HT, Gurney JW, Bozeman PM, Krance RA . Pulmonary complications of bone marrow transplantation Radiol Clin North Am 1996 34: 97ā€“117

    CASĀ  PubMedĀ  Google ScholarĀ 

  7. Ratjen F, Costabel U, Havers W . Differential cytology of bronchoalveolar lavage fluid in immunosuppressed children with pulmonary infiltrates Arch Dis Child 1996 74: 507ā€“511

    ArticleĀ  CASĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  8. Lanino E, Sacco O, Kotitsa Z et al. Fiberoptic bronchoscopy and bronchoalveolar lavage after BMT in children BoneMarrow Transplant 1996 18: 117ā€“120

    Google ScholarĀ 

  9. Pattishall EN, Noyes BE, Orenstein DM . Use of bronchoalveolar lavage in immunocompromised children withpneumonia Pediatr Pulmonol 1988 5: 1ā€“5

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  10. Stokes DC, Shenep JL, Parham D et al. Role of flexible bronchoscopy in the diagnosis of pulmonary infiltrates in pediatric patients with cancer J Pediatr 1989 115: 561ā€“567

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  11. Heurlin N, Bergstrƶm S-E, Winiarski J et al. Fungal pneumonia: the predominant lung infection causing death in children undergoing bone marrow transplantation Acta Paediatr 1996 85: 168ā€“172

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  12. Campbell JH, Blessing N, Burnet AK, Stevenson RD . Investigation and management of pulmonary infiltrates following bone marrow transplantation: an eight year review Thorax 1993 48: 1248ā€“1251

    ArticleĀ  CASĀ  PubMedĀ  PubMed CentralĀ  Google ScholarĀ 

  13. White P ., Bonacum JT, Miller CB. Utility of fiberoptic bronchoscopy in bone marrow transplant patients Bone Marrow Transplant 1997 20: 681ā€“687

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  14. Warwick AB, Mertens AC, Ou Shu X et al. Outcome following mechanical ventilation in children undergoing bone marrow transplantation Bone Marrow Transplant 1998 22: 787ā€“794

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  15. Rossi R, Shemie SD, Calderwood S . Prognosis of pediatric bone marrow transplant recipients requiring mechanical ventilation Crit Care Med 1999 27: 1181ā€“1186

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

  16. Glazer M, Breuer R, Berkman N et al. Use of fiberoptic bronchoscopy in bone marrow transplant recipients Acta Hematol 1998 99: 22ā€“26

    ArticleĀ  CASĀ  Google ScholarĀ 

  17. Snyder CL, Ramsay NK, McGlave PB et al. Diagnostic openlung biopsy after bone marrow transplantation J Pediatr Surg 1990 25: 871ā€“877

    ArticleĀ  CASĀ  PubMedĀ  Google ScholarĀ 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ben-Ari, J., Yaniv, I., Nahum, E. et al. Yield of bronchoalveolar lavage in ventilated and non-ventilated children after bone marrow transplantation. Bone Marrow Transplant 27, 191ā€“194 (2001). https://doi.org/10.1038/sj.bmt.1702773

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702773

Keywords

Search

Quick links