Controversy over Sclerotherapy for Malignant Pleural Effusions

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TO THE EDITOR:

Walker-Renard and colleagues [1] did not consider the potential use of autologous blood for pleurodesis. It has been used for various pleural diseases, including recurrent and chronic spontaneous pneumothorax [2], massive hydrothorax [3], and persistent pulmonary air leak [4].

Sedlarik and colleagues [5] described the use of electrically activated autologous blood for pleurodesis in a 48-year-old patient with malignant pleural effusions. The patient required pleurodesis of 60 mL, 50 mL, and 50 mL of electrically activated autologous blood at 10-day intervals with complete response during the 11 months the patient survived. This technique does not require a chest drain and is not associated with significant procedural or postprocedural pain. This cheap and effective method has no theoretical possibility for transmission of the human immunodeficiency virus.

Mumtaz A. Siddiqui, MD

The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:

•Include no more than 300 words of text, three authors, and five references

•Type with double-spacing

•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.

Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.

Annals welcomes electronically submitted letters.

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