The utility of lung biopsy in recipients of stem cell transplantation

James C.Y. Dunn, Karen W. West, Frederick J. Rescorla, L. R.Tres Scherer, Scott A. Engum, Thomas M. Rouse, James W. Smith, Jay L. Grosfeld

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Background/Purpose: Pulmonary infiltrates in recipients of stem cell transplantation often present as diagnostic dilemmas. Although lung biopsy may establish the diagnosis of parenchymal disease, it remains unclear whether such a procedure results in a significant change in the patient's treatment and outcome. This study evaluates the efficacy of lung biopsy in recipients of stem cell transplantation. Methods: The medical records of 15 stem cell transplant recipients who underwent 18 lung biopsies were reviewed. The indications for stem cell transplantation were leukemia in 10 patients, lymphoma in 2, histiocytosis in 1, neuroblastoma in 1, and Ewing's sarcoma in 1. The results of the lung biopsies were correlated to the clinical management and outcomes. Results: The overall mortality rate was 67% (10 patients). Eight of the 9 patients who required mechanical ventilatory support at the time of lung biopsy died. The pathologic diagnoses were pneumonitis in 6 biopsies, fibrosis in 6, brochiolitis obliterans organizing pneumonia in 3, hemorrhage in 2, and infarction in 1. Therapy was changed in 1 patient who improved after a course of steroids for bronchiolitis obliterans organizing pneumonia. Lung biopsy cultures were positive in 6 patients but rarely resulted in changes in antibiotic therapy. Conclusions: Results of very few lung biopsies performed in stem cell transplant recipients redirected therapy. Furthermore, the ultimate outcome of these patients were not improved by the results of lung biopsies.

Original languageEnglish (US)
Pages (from-to)1302-1303
Number of pages2
JournalJournal of Pediatric Surgery
Volume36
Issue number8
DOIs
StatePublished - Jan 1 2001

Keywords

  • Open lung biopsy
  • Opportunistic infection
  • Pulmonary infiltrates
  • Stem cell transplantation

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'The utility of lung biopsy in recipients of stem cell transplantation'. Together they form a unique fingerprint.

  • Cite this

    Dunn, J. C. Y., West, K. W., Rescorla, F. J., Scherer, L. R. T., Engum, S. A., Rouse, T. M., Smith, J. W., & Grosfeld, J. L. (2001). The utility of lung biopsy in recipients of stem cell transplantation. Journal of Pediatric Surgery, 36(8), 1302-1303. https://doi.org/10.1053/jpsu.2001.25799