Outcome of pulmonary complications after hematopoietic stem cell transplantation

Abstract

Abstract Background Over the past three decades, hematopoietic stem cells transplantation (HSCT)has been widely and increasingly used as standard of care for patients with congenital or acquired hematopoietic disorders. Serious systemic complications, especially pulmonary complications (PCs) both infectious and noninfectious, may occur post transplantation and may be fatal. Objective To study the incidence, types, chronology, probable risk factors as well as outcome of posttransplantation PCs in a cohort of HSCT patients who were followed-up for one year. Methods This is a prospective observational study conducted on 80 HSCT recipients who were followed-up for one year for occurrence of any respiratory symptom. A diagnostic algorithm was then followed to reach etiology of both infectious and noninfectious causes. Results Fourteen (17.5%) patients had pulmonary symptoms, 12 (86%) were due to infections and 2 (14%) were due to noninfectious causes (a case of engraftment syndrome and another of pulmonary embolism), 67% of infectious PCs and all of noninfectious PCs occurred within the first 100 days post HSCT, 60% of infectious PCs were mixed, the most common isolated pathogen was Mycoplasma pneumoniae (60%), PCs related mortality was 21%. Conclusion Post HSCT PCs are common, constituting an important cause for mortality, highlighting the necessity for appropriate clinical diagnosis and management.