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.

  • Technical Report
  • Published:

Flexible bronchoscopy in the diagnosis of pulmonary infiltrates following autologous peripheral stem cell transplantation for advanced breast cancer

Bone Marrow Transplantation volume 28, pages 981–985 (2001)Cite this article

Abstract

Flexible bronchoscopy is an important tool in the diagnosis of pulmonary complications following bone marrow transplantation. However, the value of this procedure in autologous peripheral stem cell transplant (APSCT) recipients with pulmonary complications is not well defined. We retrospectively evaluated the diagnostic yield of 27 consecutive bronchoscopies done on 23 APSCT recipients following high-dose chemotherapy for breast cancer. FB resulted in a positive diagnosis in 16 cases (59%). Broncheoalveolar lavage (BAL) was performed on all patients, and transbronchial biopsies (TBB) were carried out in 14. TBB were diagnostic in 10 (71%), with pulmonary drug toxicity as the most common finding (n = 8), followed by metastatic breast cancer (n = 2). BAL was diagnostic in six (22%): bacterial pneumonia (n = 3), aspergillosis (n = 2), Pneumocystis carinii pneumonia (n = 1) and Influenza B (n = 1). The procedure was well tolerated with no major complications except a small pneumothorax in one patient that did not require chest tube insertion. In conclusion, flexible bronchoscopy is a useful tool in the evaluation of pulmonary complications following APSCT for breast cancer. TBB can be done safely with relatively high diagnostic yield. Pulmonary drug toxicity is the most common pathological finding. Bone Marrow Transplantation (2001) 28, 981–985.

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

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

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

Similar content being viewed by others

References

  1. Krowka MJ, Rosenow EC III, Hoagland HC . Pulmonary complications of bone marrow transplantation Chest 1985 87: 237–246

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  3. Crawford SW . Supportive care in bone marrow transplantation: pulmonary complications Cancer Treat Res 1997 77: 231–254

    Article  CAS  Google Scholar 

  4. Nademanee A, Molina A, Fung H et al. High-dose chemo/radiotherapy and autologous bone marrow or stem cell transplantation for poor-risk advanced-stage Hodgkin's disease during first partial or complete remission Biol Blood Marrow Transplant 1999 5: 292–298

    Article  CAS  Google Scholar 

  5. Bhalla KS, Wilczynski SW, Abushamaa AM et al. Pulmonary toxicity of induction chemotherapy prior to standard or high-dose chemotherapy with autologous hematopoietic support Am J Respir Crit Care Med 2000 161: 17–25

    Article  CAS  Google Scholar 

  6. Graham ML, Herndon JE, Casey JR et al. High-dose chemotherapy with autologous stem-cell rescue in patients with recurrent and high-risk pediatric brain tumors J Clin Oncol 1997 15: 1814–1823

    Article  CAS  Google Scholar 

  7. Cherniack RM, Abrams J, Kalica AR . NHLBI Workshop summary. Pulmonary disease associated with breast cancer therapy Am J Respir Crit Care Med 1994 150: 1169–1173

    Article  CAS  Google Scholar 

  8. Springmeyer SC, Hackman RC, Holle R et al. Use of bronchoalveolar lavage to diagnose acute diffuse pneumonia in the immunocompromised host J Infect Dis 1986 154: 604–610

    Article  CAS  Google Scholar 

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

    Article  CAS  Google Scholar 

  10. Klein JL, Rey PM, Dansey RD et al. Cardiac sequelae of doxorubicin and paclitaxel as induction chemotherapy prior to high-dose chemotherapy and peripheral blood progenitor cell transplantation in women with hi-risk primary or metastatic breast cancer Bone Marrow Transplant 2000 20: 1047–1052

    Article  Google Scholar 

  11. Todd NW, Peters WP, Ost AH et al. Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation Am Rev Respir Dis 1993 147: 1264–1270

    Article  CAS  Google Scholar 

  12. Cordonnier C, Bernaudin JF, Fleury J et al. Diagnostic yield of bronchoalveolar lavage in pneumonitis occurring after allogeneic bone marrow transplantation Am Rev Respir Dis 1985 132: 1118–1123

    CAS  Google Scholar 

  13. Milburn HJ, Prentice HG, du Bois RM . Role of bronchoalveolar lavage in the evaluation of interstitial pneumonitis in recipients of bone marrow transplants Thorax 1987 42: 766–772

    Article  CAS  Google Scholar 

  14. McCubbin MM, Trigg ME, Hendricker CM et al. Bronchoscopy with bronchoalveolar lavage in the evaluation of pulmonary complications of bone marrow transplantation in children Pediatr Pulmonol 1992 12: 43–47

    Article  CAS  Google Scholar 

  15. Campbell JH, Blessing N, Burnett AK et al. Investigation and management of pulmonary infiltrates following bone marrow transplantation: an 8 year review Thorax 1993 48: 1248–1251

    Article  CAS  Google Scholar 

  16. Lanino E, Sacco O, Kotitsa Z et al. Fiberoptic bronchoscopy and bronchoalveolar lavage for the evaluation of pulmonary infiltrates after BMT in children Bone Marrow Transplant 1996 18: (Suppl. 2) 117–120

    Google Scholar 

  17. Dunagan DP, Baker AM, Hurd DD et al. Bronchoscopic evaluation of pulmonary infiltrates following bone marrow transplantation Chest 1997 111: 135–141

    Article  CAS  Google Scholar 

  18. Glazer M, Breuer R, Berkman N et al. Use of fiberoptic bronchoscopy in bone marrow transplant recipients Acta Haematol 1998 99: 22–26

    Article  CAS  Google Scholar 

  19. Huaringa AJ, Leyva FJ, Signes-Costa J et al. Bronchoalveolar lavage in the diagnosis of pulmonary complications of bone marrow transplant patients Bone Marrow Transplant 2000 25: 975–979

    Article  CAS  Google Scholar 

  20. Springmeyer SC, Silvestri RC, Sale GE et al. The role of transbronchial biopsy for the diagnosis of diffuse pneumonias in immunocompromised marrow transplant recipients Am Rev Respir Dis 1982 126: 763–765

    CAS  PubMed  Google Scholar 

  21. Greenman RL, Goodall PT, King D . Lung biopsy in immunocompromised hosts Am J Med 1975 59: 488–496

    Article  CAS  Google Scholar 

  22. Williams D, Yungbluth M, Adams G et al. The role of fiberoptic bronchoscopy in the evaluation of immunocompromised hosts with diffuse pulmonary infiltrates Am Rev Respir Dis 1985 131: 880–885

    CAS  PubMed  Google Scholar 

  23. Cunningham JH, Zavala DC, Corry RJ et al. Trephine air drill, bronchial brush, and fiberoptic transbronchial lung biopsies in immunosuppressed patients Am Rev Respir Dis 1977 115: 213–220

    CAS  PubMed  Google Scholar 

  24. Peters WP, Ross M, Vredenburgh JJ et al. High-dose chemotherapy and autologous bone marrow support as consolidation after standard-dose adjuvant therapy for high-risk primary breast cancer J Clin Oncol 1993 11: 1132–1143

    Article  CAS  Google Scholar 

  25. Wilczynski SW, Erasmus JJ, Petros WP et al. Delayed pulmonary toxicity syndrome following high-dose chemotherapy and bone marrow transplantation for breast cancer Am J Respir Crit Care Med 1998 157: 565–573

    Article  CAS  Google Scholar 

  26. Folz RJ . Mechanisms of lung injury after bone marrow transplantation Am J Respir Cell Mol Biol 1999 20: 1097–1099

    Article  CAS  Google Scholar 

  27. Crawford SW, Hackman RC . Clinical course of idiopathic pneumonia after bone marrow transplantation Am Rev Respir Dis 1993 147: 1393–1400

    Article  CAS  Google Scholar 

  28. Chap L, Shpiner R, Levine M et al. Pulmonary toxicity of high-dose chemotherapy for breast cancer: a non-invasive approach to diagnosis and treatment Bone Marrow Transplant 1997 20: 1063–1067

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine, Detroit Medical Center and Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA

    AO Soubani & MA Qureshi

  2. Stem Cell Transplantation Section, Detroit Medical Center and Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA

    RD Baynes

Authors
  1. AO Soubani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. MA Qureshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. RD Baynes
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

and the Stem Cell Transplantation Section

Additional information

Members of the Stem Cell Transplantation Section at Karmanos Cancer Institute: RD Dansey, JL Klein, C Hamm and E Abella

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soubani, A., Qureshi, M., Baynes, R. et al. Flexible bronchoscopy in the diagnosis of pulmonary infiltrates following autologous peripheral stem cell transplantation for advanced breast cancer. Bone Marrow Transplant 28, 981–985 (2001). https://doi.org/10.1038/sj.bmt.1703273

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1703273

Keywords

This article is cited by

Search

Advanced search

Quick links