الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 152 |  |  |
| | | from | 152 | | |
Abstract
Pulmonary complications are among the commonest and most lethal complications suffered by HSCT patients. (2)
The present study is a prospective cohort study conducted at Bone marrow transplantation unit, Ain-Shams University Hospitals during the period between January 2018 and March 2020 on 80 HSCT recipients who were randomly selected and enrolled in the study.
Different demographic, pre and post laboratory and investigational data with, special emphases on pulmonary dysfunctions and diseases, were collected from each patient and statistically analyzed.
The following results were obtained:
• The mean age of HSCT recipients was 36.83 ± 14.98 years, 62.5 % of them were males. The mean BMI was 28.63 ± 5.78 kg/m2.
• Autologous transplantation represented 63.75% of cases.
• The most common indication for HSCT was multiple myeloma 26.25%.
• Smoking history was noted in 26.25% of patients, coexisting pulmonary disease and DM were recorded in (5%, 3.75%) respectively.
• Pre-transplantation spirometric abnormality was 6.25 % obstructive pattern and 3.75 % restrictive pattern.
• Pre-transplantation abnormal radiological findings represent 5% only, in the form of hyperinflation, ILD and bronchiectasis (2.5%, 1.25%, 1.25% respectively).
• Incidence of post transplantation pulmonary complications was 17.5%, of which 85.7% was infectious and 14.28% was noninfectious in form of engraftment syndrome and pulmonary embolism.
• Approximately 66.6% of Post HSCT lower respiratory tract infections occurred in the first 3 months after transplantation and were mixed pathogens in 50 % of cases. The most common bacterial pathogen was mycoplasma pneumoniae then chlamydia pneumonia, Mycoplasma pneumoniae reported as isolated organism in 4 cases (28.57%) and mixed with other infections in 3 cases (21.42%) Chlamydia pneumonia reported as isolated organism in 1 case (7.14%) and mixed with other infections in 3cases (21.42). The only isolated viral infection was influenza A virus reported in 1 case (7.14%).
• Consolidation was the commonest radiological abnormality in CT chest of cases with pulmonary complications (14 cases) either alone in 5 cases (35.71%) or associated with pleural effusion in 4 cases (28.58 %).
• Among different factors that may be implicated in the occurrence of pulmonary complications, only male sex was found to be a significant risk factors, P =0.03.
• The patient’s age, body mass index, type of transplantation, underlying hematologic disease and pre-transplantation spirometry all had no significant correlation with the occurrence of pulmonary complications after HSCT in our study.
• The hospitalization cost was significantly (P value =0.01) higher in patients who had pulmonary complications than those who didn’t.
• Among patients with pulmonary complications, 8 cases (57. 14 %) had respiratory failure, 7 cases had type I failure (50 %) and 1 case type II failure (7.14 %). 2 cases were admitted to ICU and mechanically ventilated.
• The mortality rate from pulmonary complications was 21.43%.
• Mortality had no significant correlation with either age, history of smoking or pre-transplant pulmonary function tests.
from the present study it was concluded that:
• Post transplantation pulmonary complications were relatively common17.5%.
• The most common pulmonary complications after HSCT were infections (85.7%), most of them were mixed infections.
• Mortality rate was 21.43%.