Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1993-2-24
pubmed:abstractText
We determined risk factors present in patients with Hodgkin disease that predicted the development of diffuse alveolar hemorrhage syndrome (DAH) during autologous bone marrow transplantation (BMT). One hundred twenty-three patients with Hodgkin disease prospectively underwent bronchoscopy with bronchoalveolar lavage (BAL) before receiving BMT. The bronchitis index (BI) of the airways and bronchial and alveolar cell counts and differentials were determined in all patients and compared with 20 normal nonsmoking volunteers. Logistic regression analysis was used to determine factors that predicted for the development of DAH. Visual evidence of bronchial injury was observed regardless of smoking history (BI = 7.8 +/- 0.5 for BMT versus 2.3 +/- 0.5 for volunteers, p = 0.001). BMT patients who developed DAH (n = 14) had significantly greater numbers of bronchial neutrophils and eosinophils compared with DAH-negative (n = 109) patients (bronchial polymorphonuclear leukocytes (PMN), 33 +/- 7% versus 14 +/- 2%, p = 0.006; bronchial eosinophils, 0.9 +/- 0.3% versus 0.4% +/- 0.07%, p = 0.02). Logistic regression analysis revealed that the presence of bronchial PMN > 20% or bronchial eosinophils > zero% were predictive of DAH (p = 0.005 and 0.05, respectively). When both predictors were positive, the rate of DAH was 10 times greater than when both predictors were negative (43% versus 4% DAH occurrence). Survival was also significantly reduced when these predictors were positive. This study demonstrates that bronchial inflammation is present with or without intraluminal inflammatory cells in the majority of patients with Hodgkin disease before BMT. The subgroup of these patients with increased bronchial inflammatory cells are at greatly increased risk for development of DAH and death.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
0003-0805
pubmed:author
pubmed:issnType
Print
pubmed:volume
146
pubmed:owner
NLM
pubmed:authorsComplete
N
pubmed:pagination
439-43
pubmed:dateRevised
2006-4-24
pubmed:meshHeading
pubmed-meshheading:1489136-Academic Medical Centers, pubmed-meshheading:1489136-Adult, pubmed-meshheading:1489136-Antineoplastic Combined Chemotherapy Protocols, pubmed-meshheading:1489136-Bone Marrow Transplantation, pubmed-meshheading:1489136-Bronchitis, pubmed-meshheading:1489136-Bronchoalveolar Lavage Fluid, pubmed-meshheading:1489136-Bronchoscopy, pubmed-meshheading:1489136-Combined Modality Therapy, pubmed-meshheading:1489136-Eosinophils, pubmed-meshheading:1489136-Female, pubmed-meshheading:1489136-Hemorrhage, pubmed-meshheading:1489136-Hodgkin Disease, pubmed-meshheading:1489136-Humans, pubmed-meshheading:1489136-Inflammation, pubmed-meshheading:1489136-Male, pubmed-meshheading:1489136-Mass Screening, pubmed-meshheading:1489136-Nebraska, pubmed-meshheading:1489136-Neutrophils, pubmed-meshheading:1489136-Population Surveillance, pubmed-meshheading:1489136-Predictive Value of Tests, pubmed-meshheading:1489136-Prospective Studies, pubmed-meshheading:1489136-Pulmonary Alveoli, pubmed-meshheading:1489136-Risk Factors, pubmed-meshheading:1489136-Syndrome
pubmed:year
1992
pubmed:articleTitle
Airway inflammation predicts diffuse alveolar hemorrhage during bone marrow transplantation in patients with Hodgkin disease.
pubmed:affiliation
Department of Medicine, University of Nebraska Medical Center, Omaha 68198-2465.
pubmed:publicationType
Journal Article