Pulmonary Complications in Egyptian Bone Marrow Transplantation Recipients and their Effect on the Outcome of Transplant: A Single Center Experience

Abstract

Abstract Background Pulmonary complications, both infectious and non- infectious, are found in 40%–60% of all Bone Marrow Transplantation recipients, which lead to a significant morbidity and mortality. In some studies, pulmonary complications are the main cause of 50% of all deaths in this population, and patients with these complications have a higher mortality rate than those without such complications Aim This study is to evaluate the pulmonary complications in BMT Recipients and their effect on the outcome in these Patients Patients and Methods Our study was a retrospective-prospective Cohort clinical study on 150 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. Patients were subjected to blood and sputum examination with sputum culture for fungi if suspected fungal infection, High resolution CT chest along with spirometry if indicated. Results 150 patients were studied for Pulmonary complications either infectious or noninfectious after HSCT where pulmonary complications were found in 48% of patients, 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% of death 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 Pulmonary complications are a major complication after BMT affecting the patients' prognosis, They represent significant cause of mortality and bacterial pneumonia is a highly significant factor for death in those population, The first 100 days after BMT are the most critical period