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Corticosteroid Therapy for Diffuse Alveolar Hemorrhage in Autologous Bone Marrow Transplant Recipients
- Nelson J. Chao, MD;
- Steven R. Duncan, MD;
- Gwynn D. Long, MD;
- Sandra J. Horning, MD; and
- Karl G. Blume, MD
Excerpt
Robbins and colleagues (1) recently reported a syndrome of diffuse alveolar hemorrhage seen in patients after autologous bone marrow transplantation. This entity was noted in 29 of 141 patients (21%) and was associated with an 80% mortality rate (23 of the 29 patients died). Risk factors associated with the development of this syndrome included age over 40 years, underlying solid tumors, high fevers, severe mucositis, leukocyte recovery, and renal insufficiency. The Memorial Sloan-Kettering group (2) also recently reported their experience with pulmonary complications after autologous bone marrow transplantation. Pulmonary hemorrhage was seen 11 of 31 patients (35%) receiving transplants for
Acknowledgments
Acknowledgments: The authors thank the Stanford medical housestaff and hematology and oncology fellows and the staff of the Compromised Host Unit for patient care.
Article and Author Information
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From the Stanford University Medical Center, Stanford, California. For current author addresses, see end of text.
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Grant Support: By grant CA 49605 from the National Institutes of Health.
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Requests for Reprints: Nelson J. Chao, MD, Bone Marrow Transplantation Program, H-1353, Stanford University Medical Center, Stanford, CA 94305.
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Current Author Addresses: Drs. Chao and Blume: Bone Marrow Transplantation Program, H-1353, Stanford University Medical Center, Stanford, CA 94305.
Drs. Long and Horning: Division of Medical Oncology, M-211, Stanford University Medical Center, Stanford, CA 94305.
Dr. Duncan: Pulmonary and Critical Care Medicine, University of Pittsburgh, 440 Scaife Hall, Pittsburgh, PA 15261.
