The Significance of Radiologic Positive Finding of Paranasal Sinus in Bone Marrow Transplant Patients

ABSTRACT

BACKGROUND: Bone marrow transplantation (BMT) is a beneficial and curative technique used in different hematologic conditions or malignant neoplastic diseases. However, bone marrow transplant patients are at a higher risk of developing infections and complications due to previous chemotherapy, radiotherapy, immunosuppression, antibiotics therapy, multiple viral infections, and GVHD (graft-versus-host disease). OBJECTIVES: The purpose of this study is to determine the prevalence and clinical data of rhinosinusitis among patients with BMT. We also investigated whether pre-BMT positive radiologic finding could predispose patients to the development of post-BMT rhinosinusitis or not. MATERIALS AND METHODS: We reviewed the records of 203 patients who had received BMT in Kyungpook National University's hospital from September 1998 to August 2006. RESULT: Sixteen patients (7.8%) had radiologic positive finding before BMT. Fifteen patients had no sinonasal symptoms and did not get any treatment. Only one patient had rhinosinusitis so that BMT was delayed and treated with antibiotics. Among these patients, one patient got newly developed rhinosinusitis after BMT. After BMT, sinusitis developed in ten patients (4.9%), including one patient who had invasive fungal sinusitis. Our study revealed a higher incidence of rhinosinusitis among allogenic BMT patients than among autologous BMT patients. The most common symptoms and signs were fever. Only one patient complained of typical sinonasal symptoms. CONCLUSION: Even though the prevalence of rhinosinusitis is low (4.9%) among post-BMT patients, maintenance of a high index of suspicion among these patients is necessary because sinonasal symptoms and signs are generally minimized after BMT. The study concluded that pre-BMT positive radiologic findings without sinonasal symptoms is unlikely to develop post-BMT rhinosinusitis.