A Prospective Assessment of the Diagnostic Utility of Emerging Laboratory Assessments Used in Conjunction With Fiberoptic Bronchoscopy (FOB) in Hematopoietic Stem Cell Transplant (HSCT) and Leukemia Patients With Acute Respiratory Symptoms and Pulmonary Infiltrates

Trial Information

A Prospective Assessment of the Diagnostic Utility of Emerging Laboratory Assessments Used in Conjunction With Fiberoptic Bronchoscopy (FOB) in Hematopoietic Stem Cell Transplant (HSCT) and Leukemia Patients With Acute Respiratory Symptoms and Pulmonary Infiltrates

Proper diagnosis and prompt treatment favorably impacts survival in the post transplant
setting, but is often difficult and frequently results in inappropriate or late therapy. Low
yields may be linked with empiric antibody therapy begun prior to the procedure, delayed
time to procedure, procedure technique, the presence of graft versus host disease (GVHD),
neutropenia, and diffuse infiltrates (as opposed to localized infiltrates or focal masses
and nodules). One recent study found that early FOBs (less than or equal to 4 days between
detection of pulmonary infiltrates and FOB) were 2.5 times more likely to establish a
diagnosis of pneumonia compared to late examinations. Delaying this procedure(greater than 5
days between detection of pulmonary infiltrates and FOB) was associated with drug resistant
organisms, polymicrobial infections, and worsened patient prognosis.