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Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation

BACKGROUND: Mature blood cells can be differentiated from hematopoietic stem cells; thus, the latter can play a crucial role in maintaining defense against different microorganisms. Thus, hematopoietic stem cell transplantation is one of the most important lines of immunotherapy. Major systemic comp...

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Autores principales: Zidan, Mohamed, Nafea, Dalia Ahmed, Okasha, Hadir Ahmed Said, Abouelnour, Ahmed Farag, Eshmawey, Heba Ahmed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527666/
http://dx.doi.org/10.1186/s43168-020-00032-z
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author Zidan, Mohamed
Nafea, Dalia Ahmed
Okasha, Hadir Ahmed Said
Abouelnour, Ahmed Farag
Eshmawey, Heba Ahmed
author_facet Zidan, Mohamed
Nafea, Dalia Ahmed
Okasha, Hadir Ahmed Said
Abouelnour, Ahmed Farag
Eshmawey, Heba Ahmed
author_sort Zidan, Mohamed
collection PubMed
description BACKGROUND: Mature blood cells can be differentiated from hematopoietic stem cells; thus, the latter can play a crucial role in maintaining defense against different microorganisms. Thus, hematopoietic stem cell transplantation is one of the most important lines of immunotherapy. Major systemic complications may occur post transplantation and could be fatal. Pulmonary complications include infectious and non-infectious complications. The aim of this study was to detect the pulmonary complications in allogeneic stem cell transplantation patients. RESULTS: We studied 20 patients after transplantation of allogeneic stem cells with regular follow-up in outpatient clinic of hematology department of Alexandria Main University Hospital. All the studied patients were subjected to history taking, plain x-ray chest PA view, CT chest, complete blood count, serum creatinine, liver enzymes, and serum cytomegalovirus (CMV) detection by antibodies IgG and IgM. Regarding sputum sampling, 7 patients’ samples (35%) were obtained either spontaneously or by induction via hypertonic saline 3%. One patient (5%) had miniBAL done, while bronchoalveolar lavage using fiber optic bronchoscopy was done for 2 patients (10%). Samples could not be obtained from the remaining patients. Samples were analyzed for culture for bacteria, Pneumocystis jiroveci using immunofluorescence test, CMV PCR, fungal culture, and smear for acid fast bacilli (AFB). Among the examined patients, 2 patients (20%) had pulmonary bacterial infection including streptococcus and multidrug-resistant strain of Klebsiella, 3 patients (30%) had pulmonary candida infection, and one patient (10%) had positive result of pulmonary CMV of low count which was considered insignificant. None of our patients had positive results for pulmonary tuberculosis nor Pneumocystis jiroveci. Six patients (30%) had CMV in serum; 3 patients (15.8%) had manifested CMV reactivation. One patient (5%) of our patients had pulmonary graft versus host disease GVHD. One patient (5%) had died during our study course within 12 days post-transplantation due to ARDS followed by multiple organ failure. CONCLUSION: The prevalence of pulmonary infectious complications after allogenic stem cell transplantation was 50% of all studied patients, while 5% of the studied patients presented with non-infectious pulmonary complications.
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spelling pubmed-75276662020-10-01 Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation Zidan, Mohamed Nafea, Dalia Ahmed Okasha, Hadir Ahmed Said Abouelnour, Ahmed Farag Eshmawey, Heba Ahmed Egypt J Bronchol Research BACKGROUND: Mature blood cells can be differentiated from hematopoietic stem cells; thus, the latter can play a crucial role in maintaining defense against different microorganisms. Thus, hematopoietic stem cell transplantation is one of the most important lines of immunotherapy. Major systemic complications may occur post transplantation and could be fatal. Pulmonary complications include infectious and non-infectious complications. The aim of this study was to detect the pulmonary complications in allogeneic stem cell transplantation patients. RESULTS: We studied 20 patients after transplantation of allogeneic stem cells with regular follow-up in outpatient clinic of hematology department of Alexandria Main University Hospital. All the studied patients were subjected to history taking, plain x-ray chest PA view, CT chest, complete blood count, serum creatinine, liver enzymes, and serum cytomegalovirus (CMV) detection by antibodies IgG and IgM. Regarding sputum sampling, 7 patients’ samples (35%) were obtained either spontaneously or by induction via hypertonic saline 3%. One patient (5%) had miniBAL done, while bronchoalveolar lavage using fiber optic bronchoscopy was done for 2 patients (10%). Samples could not be obtained from the remaining patients. Samples were analyzed for culture for bacteria, Pneumocystis jiroveci using immunofluorescence test, CMV PCR, fungal culture, and smear for acid fast bacilli (AFB). Among the examined patients, 2 patients (20%) had pulmonary bacterial infection including streptococcus and multidrug-resistant strain of Klebsiella, 3 patients (30%) had pulmonary candida infection, and one patient (10%) had positive result of pulmonary CMV of low count which was considered insignificant. None of our patients had positive results for pulmonary tuberculosis nor Pneumocystis jiroveci. Six patients (30%) had CMV in serum; 3 patients (15.8%) had manifested CMV reactivation. One patient (5%) of our patients had pulmonary graft versus host disease GVHD. One patient (5%) had died during our study course within 12 days post-transplantation due to ARDS followed by multiple organ failure. CONCLUSION: The prevalence of pulmonary infectious complications after allogenic stem cell transplantation was 50% of all studied patients, while 5% of the studied patients presented with non-infectious pulmonary complications. Springer Berlin Heidelberg 2020-10-01 2020 /pmc/articles/PMC7527666/ http://dx.doi.org/10.1186/s43168-020-00032-z Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research
Zidan, Mohamed
Nafea, Dalia Ahmed
Okasha, Hadir Ahmed Said
Abouelnour, Ahmed Farag
Eshmawey, Heba Ahmed
Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title_full Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title_fullStr Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title_full_unstemmed Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title_short Evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
title_sort evaluation of pulmonary complications in patients undergoing allogenic stem cell transplantation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527666/
http://dx.doi.org/10.1186/s43168-020-00032-z
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