الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
P
ulmonary complications, including infectious and non-infectious, occur in 40%–60% of all Bone Marrow Transplantation recipients, which accounts for a considerable morbidity and mortality, where according to some studies, pulmonary complications account for 50% of all deaths in this population, and patients with pulmonary complications have a higher mortality rate than those without such complications.
The aim of this study is to evaluate the pulmonary Complications in BMT Recipients and their Effect on the outcome in these Patients and to achieve this, the study was conducted upon 150 patients, it was a retrospective-prospective Cohort clinical study done for patients who underwent Bone Marrow Transplantation (allogeneic and autologous) in Wadi El-Neel Hospital. It was for 2 years in patients who underwent the procedure in 2017 (one year retrospective from 2017 to 2018 and one year prospective from 2018 to 2019) and for one year in those who underwent it in 2018 (prospective from 2018 to 2019) and we continued the follow up of all cases till the end of 2019, Laboratory, radiological and spirometry (in selected patients) data were collected and analysed to evaluate pulmonary complications in those patients.
Pulmonary complications were found in 48% of patients and that the most common pulmonary complication was Bacterial pneumonia in 14.7%, 50 patients (33.3% of patients) died; The cause was predominantly pulmonary in 28 patients (56%) of the deaths; 88% died in the first 100 days with 66% of them in the first 30 days, the pulmonary complications related mortality in those 28 patients, 54.8% were due to infectious causes and 5.8% were due to non-infectious causes with 22 patients of infectious causes (95.7%) died within 100 days, also, presence of CT chest abnormalities has an independent effect on survival time for those patients.
CONCLUSION
- The most common diagnosis among patients needing BMT was Leukemia
- Most patients underwent Allogenic bone marrow transplantation
- Pulmonary complications either infectious or noninfectious are a major complication after BMT affecting the patients’ prognosis.
- Pulmonary complications represent significant cause of mortality in those patients.
- Pulmonary complications related mortality was more due to infectious causes.
- Bacterial pneumonia is a high significant factor for death in those population.
- The first 100 days after BMT are the most critical period especially the first 30 days where most of the mortality rate occurs in this period.
- Presence of CT chest abnormalities significantly affects survival time in those patients.
- Good prophylaxis against CMV and PCP markedly decrease morbidity and mortality in those patients.
Limitation of the study:
Regarding patients in the retrospective period of the study; there was no enough data regarding the Disease Free Survival rate which did not allow us to fulfill this point.
RECOMMENDATIONS
- To study pulmonary complications in BMT patients over a larger number of patients and if the type of BMT (either autolegous or allogenic) affects their incidence.
- To study pulmonary complications in BMT patients for a longer period of time to assess their effect on patients’ prognosis in relation to time especially the non-infectious complications.
- Good screening for viruses especially CMV IgM and IgG in both donors and recepients before BMT.
- Good immunization and prophylaxis for BMT recipients to decrease risk of infection and so decreasing morbidity and mortality.
- Early detection and treatment of any detected infection in those patients.
- Early detection and treatment of any detected pulmonary complication in those patients either infectious or noninfectious.
- High resolution CT chest is mandatory if pulmonary complication is suspected in BMT recipients.
- Spirometry if Bronchiolitis Obliterans is suspected for early detection and follow up.