Utility of flexible bronchoscopy with polymerase chain reaction in the diagnosis and management of pulmonary infiltrates in allogeneic HSCT patients
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd..
OBJECTIVES: Pulmonary infiltrates in allogeneic hematopoietic stem cell transplant (allo-HSCT) patients are potentially life-threatening and require early diagnosis and treatment. We aimed to retrospectively explore the clinical efficacy of polymerase chain reaction (PCR) in conjunction with flexible bronchoscopy (FB) in allo-HSCT patients with pulmonary infiltrates.
PATIENTS AND METHODS: We retrospectively reviewed all patients undergoing FB after allo-HSCT at the Peking University Institute of Hematology from January 2013 to December 2016. We used PCR to detect various viruses in FB specimens, particularly for 27 viruses.
RESULTS: One hundred forty-nine diagnostic FBs were performed in 130 patients. The overall diagnostic yield was 58%. Eighty-nine percent of the patients with a positive FB result were diagnosed with a pulmonary infection. Viruses were the most common infectious diagnosis (70%), followed by fungi (48%), bacteria (38%), and Pneumocystis jirovecii (12%). Multivariate analyses showed that a chest computed tomography (CT) finding of diffuse pulmonary infiltrates (P = .012) and positive results in assisted microbiological and serological analyses (P = .000) predicted a positive FB result. FB results prompted a treatment modification in 61% of cases.
CONCLUSIONS: FB in conjunction with PCR is efficient in the rapid diagnosis and management of pulmonary infiltrates in allo-HSCT patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
Clinical transplantation - 32(2018), 1 vom: 01. Jan. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tang, Fei-Fei [VerfasserIn] |
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| Links: |
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| Themen: |
Anti-Infective Agents |
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| Anmerkungen: |
Date Completed 28.05.2019 Date Revised 18.04.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/ctr.13146 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM277578744 |
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| 245 | 1 | 0 | |a Utility of flexible bronchoscopy with polymerase chain reaction in the diagnosis and management of pulmonary infiltrates in allogeneic HSCT patients |
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| 500 | |a Date Completed 28.05.2019 | ||
| 500 | |a Date Revised 18.04.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. | ||
| 520 | |a OBJECTIVES: Pulmonary infiltrates in allogeneic hematopoietic stem cell transplant (allo-HSCT) patients are potentially life-threatening and require early diagnosis and treatment. We aimed to retrospectively explore the clinical efficacy of polymerase chain reaction (PCR) in conjunction with flexible bronchoscopy (FB) in allo-HSCT patients with pulmonary infiltrates | ||
| 520 | |a PATIENTS AND METHODS: We retrospectively reviewed all patients undergoing FB after allo-HSCT at the Peking University Institute of Hematology from January 2013 to December 2016. We used PCR to detect various viruses in FB specimens, particularly for 27 viruses | ||
| 520 | |a RESULTS: One hundred forty-nine diagnostic FBs were performed in 130 patients. The overall diagnostic yield was 58%. Eighty-nine percent of the patients with a positive FB result were diagnosed with a pulmonary infection. Viruses were the most common infectious diagnosis (70%), followed by fungi (48%), bacteria (38%), and Pneumocystis jirovecii (12%). Multivariate analyses showed that a chest computed tomography (CT) finding of diffuse pulmonary infiltrates (P = .012) and positive results in assisted microbiological and serological analyses (P = .000) predicted a positive FB result. FB results prompted a treatment modification in 61% of cases | ||
| 520 | |a CONCLUSIONS: FB in conjunction with PCR is efficient in the rapid diagnosis and management of pulmonary infiltrates in allo-HSCT patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a flexible bronchoscopy | |
| 650 | 4 | |a hematopoietic stem cell transplantation | |
| 650 | 4 | |a polymerase chain reaction | |
| 650 | 4 | |a pulmonary infiltrate | |
| 650 | 7 | |a Anti-Infective Agents |2 NLM | |
| 700 | 1 | |a Zhao, Xiao-Su |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Lan-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xiao-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yu-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Mo, Xiao-Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kai-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Xiao-Jun |e verfasserin |4 aut | |
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