Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
2006-10-27
pubmed:abstractText
Diffuse alveolar hemorrhage (DAH) is a noninfectious pulmonary complication of hematopoietic stem cell transplantation (HSCT) with unclear pathogenesis and treatment. We reviewed prospectively collected data on 1919 consecutive transplants performed between 1995 and 2004 and compared patients with DAH and infection-associated alveolar hemorrhage (IAH) who presented with similar symptoms of hypoxemia, pulmonary infiltrates, and progressively bloody alveolar lavage but also had microorganisms isolated from blood, bronchoalveolar lavage, or tracheal aspirate within 1 week of alveolar hemorrhage. Overall, 116 patients had alveolar hemorrhage (45 with DAH, 71 with IAH). Older age, allogeneic donor source, myeloablative conditioning regimen, and acute severe graft-versus-host disease (GVHD) were independently predictive of an increased risk of post-HSCT alveolar hemorrhage. The DAH and IAH groups were comparable except for a higher proportion of patients receiving umbilical cord blood as a donor source and total-body irradiation-containing conditioning in the IAH group. The probability of 60-day survival from onset of hemorrhage was 16% (95% CI, 6%-26%) for the DAH and 32% (95% CI, 21%-43%) for the IAH group (P = .08). All except 20 patients were treated with a standard regimen of high-dose corticosteroids. Patients who received corticosteroids had 60-day survival of 26% (95% CI, 18%-34%), compared with 25% (95% CI, 6%-44%) for those who did not (P = .28). The pathogenesis of alveolar hemorrhage after HSCT is multifactorial, and we propose that IAH and DAH in HSCT recipients are related clinical syndromes with similar clinical presentation, risks, and associated high mortality.
pubmed:commentsCorrections
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1083-8791
pubmed:author
pubmed:issnType
Print
pubmed:volume
12
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1038-46
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed-meshheading:17067910-Adolescent, pubmed-meshheading:17067910-Adult, pubmed-meshheading:17067910-Age Factors, pubmed-meshheading:17067910-Aged, pubmed-meshheading:17067910-Bone Marrow Transplantation, pubmed-meshheading:17067910-Bronchoalveolar Lavage Fluid, pubmed-meshheading:17067910-Child, pubmed-meshheading:17067910-Child, Preschool, pubmed-meshheading:17067910-Cohort Studies, pubmed-meshheading:17067910-Cord Blood Stem Cell Transplantation, pubmed-meshheading:17067910-Female, pubmed-meshheading:17067910-Graft vs Host Disease, pubmed-meshheading:17067910-Hematopoietic Stem Cell Transplantation, pubmed-meshheading:17067910-Hemorrhage, pubmed-meshheading:17067910-Humans, pubmed-meshheading:17067910-Kaplan-Meier Estimate, pubmed-meshheading:17067910-Lung Diseases, pubmed-meshheading:17067910-Male, pubmed-meshheading:17067910-Methylprednisolone, pubmed-meshheading:17067910-Middle Aged, pubmed-meshheading:17067910-Peripheral Blood Stem Cell Transplantation, pubmed-meshheading:17067910-Pneumonia, pubmed-meshheading:17067910-Postoperative Complications, pubmed-meshheading:17067910-Proportional Hazards Models, pubmed-meshheading:17067910-Prospective Studies, pubmed-meshheading:17067910-Pulmonary Alveoli, pubmed-meshheading:17067910-Risk, pubmed-meshheading:17067910-Risk Factors, pubmed-meshheading:17067910-Staphylococcal Infections, pubmed-meshheading:17067910-Transplantation, Homologous, pubmed-meshheading:17067910-Transplantation Conditioning, pubmed-meshheading:17067910-Whole-Body Irradiation
pubmed:year
2006
pubmed:articleTitle
Diffuse alveolar hemorrhage and infection-associated alveolar hemorrhage following hematopoietic stem cell transplantation: related and high-risk clinical syndromes.
pubmed:affiliation
Blood and Marrow Transplant Program, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN 55455, USA. majha001@umn.edu
pubmed:publicationType
Journal Article