Abstract
Background. Pulmonary complications after hematopoietic stem cell transplantation (HSCT) are common and sometimes fatal. Although they are classified as either infectious or non-infectious, they are often difficult to differentiate, and therefore bronchoscopy is considered an important tool for investigating such complications. Objective and Methods. In the present study, we compared the clinical characteristics of pulmonary complications that developed in patients with hematological diseases after HSCT with those that developed in patients who had not undergone HSCT. We retrospectively analyzed the underlying diseases, chest radiological findings, bronchoscopic findings and lung symptom outcomes after bronchoscopy in 42 patients (post-HSCT, n=13; non-HSCT, n=29) to diagnose abnormal chest shadows associated with hematological diseases over the past 10 years at our hospital. Results. Leukemia and multiple myeloma were the most frequently noted underlying diseases in the post-and non-HSCT groups, respectively. Bronchoscopic examinations provided a definitive diagnosis in 12 (92.3%) and 21 (72.4%) patients in the post-and non-HSCT groups, respectively. Among the definitively diagnosed diseases, non-infectious pulmonary complications were more frequently found than infectious diseases in the post-HSCT group (n=8, 61.5%), whereas infectious pulmonary complications were more frequently found than non-infectious diseases in the non-HSCT group (n=15, 51.7%). These findings were significantly different (p=0.02; χ^2 test). Non-infectious pulmonary complications tended to be associated with a poor prognosis in both groups. No serious complications resulted from the bronchoscopic procedure, which positively influenced the subsequent management of lung symptoms in 9 (69.2%) and 15 (51.7%) patients the post-and non-HSCT groups, respectively. Conclusion. We speculate that a history of treatment with HSCT influences the etiology of abnormal chest shadows in patients with concurrent hematological disease.
