Abstract
Hematolojik maligniteli hastalarda genel olarak morbidite ve mortalitenin en önemli nedeni enfeksiyonlardır. Hematolojik malignitelerde ciddi enfeksiyonlara neden olan en sık risk faktörü, sitotoksik kemoterapiye bağlı nötropenidir. Nötropenik hastalarda pulmoner infiltrasyonlar çok sık görülmektedir ve ciddi komplikasyonlara yol açmaktadırlar. Nötropenik hastalarda görülen akciğer infiltrasyonu sıklıkla fungal enfeksiyonlara atfedilir fakat bu infiltrasyonlar bakteriyel, viral ve mikobakteriyel de olabilir. Son yıllarda, gelişmiş ülkelerde tüberküloz insidansı azalmakla beraber, gelişmekte olan ülkelerde beslenme yetersizliği, kalabalık ortamlarda yaşama ve tüberkülozun kötü kontrol edilmesi nedeniyle halen yüksek prevalansta bulunmaktadır. Pulmoner infiltrasyonun etyolojisini aydınlatmak için bazen radyolojik yöntemler yeterli olurken, bazen de transbronşiyal biyopsi ve bronkoalveolar lavaj gibi invazif girişimler de gerekebilmektedir. İnatçı veya tekrarlayan ateşi olan nötropenik hastalarda invazif fungal enfeksiyonlar nedeniyle ampirik veya preemptif tedavi gerekmektedir.
Keywords
References
- Demirkazik FB, Akin A, Uzun O, Akpinar MG, Ariyürek MO. CT findings in immunocompro- mised patients with pulmonary infections. Diagn Interv Radiol 2008; 14: 75-82.
- Itoh Y, Segawa H, Kito K, Hodohara K, Ishigaki H, Sugihara H, Fujiyama Y, Ogasawara K. Lipoid pneumonia with chronic myelomono- cytic leukemia. Pathol Res Pract 2009; 205: 143-7.
- Ewig S, Glasmacher A, Ulrich B, Wilhelm K, Schäfer H, Nachtsheim KH. Pulmonary infilt- rates in neutropenic patients with acute leukemia during chemotherapy: outcome and prognostic factors. Chest 1998; 114: 444-51.
- Kakihana K, Ohashi K, Sakai F, Kamata N, Hosomi Y, Nishiwaki M, Yokoyama R, Kobayashi T, Yamashita T, Akiyama H, Sakamaki H. Leukemic infiltration of the lung following allogeneic hematopoietic stem cell transplan- tation. Int J Hematol 2009; 89: 118-22.
- Farris AB 3rd, Hasserjian RP, Zukerberg LR, Amrein PC, Greene RE, Mark EJ, Kradin RL. Diffuse Cellular and Fibrosing Interstitial Pneumonitis With Desquamative Interstitial Pneumonitis-like Features Associated With Myeloid Neoplasia. Am J Surg Pathol 2009; 3 [Epub ahead of print].
- Wu YK, Huang YC, Huang SF, Huang CC, Tsai YH. Acute respiratory distress syndrome caused by leukemic infiltration of the lung. J Formos Med Assoc 2008; 107: 419-23.
- Rieger CT, Rieger H, Kolb HJ, Peterson L, Huppmann S, Fiegl M, Ostermann H. Infec- tious complications after allogeneic stem cell transplantation: incidence in matched-related SONUÇ
- Hematolojik malignitelerin seyri sırasında
- hem hastalığa hem de kemoterapi tedavisi
- nin neden olduğu immunsupresyon nede
- niyle sık görülen pulmoner komplikasyon
- lara, morbidite ve mortaliteye yol açtıkları
- için, hızlı, sistematik ve multidispliner yak
- laflım gerekmektedir.
MANAGEMENT OF PULMONARY COMPLICATIONS THAT CAN BE OCCURED AMONG THE PATIENTS WITH HEMATOLOGIC MALIGNANCY
Abstract
Infections are the major cause of morbidity and mortality in patients with hematologic malignancies. Neutropenia, resulting from cytotoxic chemotherapy is the most common risk factor for severe infections in hematological malignancies. Pulmonary infiltrates in neutropenic patients cause frequent and serious complications. In neutropenic patients, the infiltration of the lung, are frequently attributed to fungal infections. But the cause of infection can be bacterial, viral or mycobacterial. In recent years, tuberculosis incidence has declined in high-income countries, but incidence remains high in developing countries that have high prevalence of malnutrition, crowded living conditions, or poor tuberculosis control. Radiologic findings may be helpful in predicting the etiology of pulmonary infiltration but some invasive procedures, such as transbronchial biopsy and bronchoalveolar lavage may be required. Empirical treatment or preemptive treatment for invasive fungal infections is needed among neutropenic patients with persistent or recurrent fever.
Keywords
References
- Demirkazik FB, Akin A, Uzun O, Akpinar MG, Ariyürek MO. CT findings in immunocompro- mised patients with pulmonary infections. Diagn Interv Radiol 2008; 14: 75-82.
- Itoh Y, Segawa H, Kito K, Hodohara K, Ishigaki H, Sugihara H, Fujiyama Y, Ogasawara K. Lipoid pneumonia with chronic myelomono- cytic leukemia. Pathol Res Pract 2009; 205: 143-7.
- Ewig S, Glasmacher A, Ulrich B, Wilhelm K, Schäfer H, Nachtsheim KH. Pulmonary infilt- rates in neutropenic patients with acute leukemia during chemotherapy: outcome and prognostic factors. Chest 1998; 114: 444-51.
- Kakihana K, Ohashi K, Sakai F, Kamata N, Hosomi Y, Nishiwaki M, Yokoyama R, Kobayashi T, Yamashita T, Akiyama H, Sakamaki H. Leukemic infiltration of the lung following allogeneic hematopoietic stem cell transplan- tation. Int J Hematol 2009; 89: 118-22.
- Farris AB 3rd, Hasserjian RP, Zukerberg LR, Amrein PC, Greene RE, Mark EJ, Kradin RL. Diffuse Cellular and Fibrosing Interstitial Pneumonitis With Desquamative Interstitial Pneumonitis-like Features Associated With Myeloid Neoplasia. Am J Surg Pathol 2009; 3 [Epub ahead of print].
- Wu YK, Huang YC, Huang SF, Huang CC, Tsai YH. Acute respiratory distress syndrome caused by leukemic infiltration of the lung. J Formos Med Assoc 2008; 107: 419-23.
- Rieger CT, Rieger H, Kolb HJ, Peterson L, Huppmann S, Fiegl M, Ostermann H. Infec- tious complications after allogeneic stem cell transplantation: incidence in matched-related SONUÇ
- Hematolojik malignitelerin seyri sırasında
- hem hastalığa hem de kemoterapi tedavisi
- nin neden olduğu immunsupresyon nede
- niyle sık görülen pulmoner komplikasyon
- lara, morbidite ve mortaliteye yol açtıkları
- için, hızlı, sistematik ve multidispliner yak
- laflım gerekmektedir.
Details
| Other ID | JA85NR93BU |
|---|---|
| Journal Section | Collection |
| Authors | |
| Publication Date | May 1, 2010 |
| Published in Issue | Year 2010 Volume: 24 Issue: 1 |