ABSTRACT
BACKGROUND: Children with leukemia are at risk of developing life-threatening opportunistic pulmonary infections. The role of bronchoalveolar lavage (BAL) and lung biopsy (BX) in the management of these patients is controversial. In this study, we evaluate the yield and safety of BAL and BX in children with leukemia. PROCEDURE: We reviewed the records of all children with leukemia who underwent either BAL or BX between 1997 and 2007 at the St Jude Children's Research Hospital. RESULTS: A total of 64 patients were included, of whom 35 (55%) had BX and 29 (45%) had BAL. Positive results were obtained in 69% of BAL cohort and in 46% of BX cohort. Both procedures resulted in change in antimicrobial coverage (77% in BX, 83% in BAL). Pulmonary hemorrhage occurred in 2 patients, and transient hypoxia was the most frequent complication. All resolved without negatively impacting the clinical course. CONCLUSIONS: Both BAL and BX are safe and useful in the management of children with leukemia and pulmonary disease.
Subject(s)
Anti-Infective Agents/therapeutic use , Bronchoalveolar Lavage , Leukemia/complications , Lung Diseases/diagnosis , Lung/pathology , Biopsy , Child , Disease Management , Female , Hemorrhage , Humans , Hypoxia , Lung Diseases/complications , Lung Diseases/drug therapy , Lung Diseases/etiology , Male , Retrospective StudiesABSTRACT
Myelosuppression associated with antineoplastic therapy may lead to neutropenia, anemia, or both, resulting in an increased risk for infection, fatigue, diminished quality of life, and reduced survival. Neutropenia can result in dose reductions and treatment delays. Hematopoietic growth factors have been used effectively as supportive therapy to reduce antineoplastic therapy-associated neutropenia and anemia. This article discusses management of neutropenia and anemia secondary to antineoplastic therapy, new medications, and nursing considerations.
