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[Clinical value of PCR for viral detection of bronchoalveolar lavage fluid in the diagnosis and treatment of pneumonia after allogeneic hematopoietic stem cell transplantation].
Chen, Y Y; Luo, X Y; Zhao, X S; Jiang, Z H; Chen, Y; Chen, H; Mo, X D; Han, W; Wang, F R; Wang, J Z; Yan, C H; Sun, Y Q; Zhang, Y Y; Han, T T; Tang, F F; Fu, H X; Zhang, S; Wang, Y; Xu, L P; Zhang, X H; Liu, K Y; Huang, X J.
Affiliation
  • Chen YY; Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Lab of HSCT, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi ; 38(11): 934-939, 2017 Nov 14.
Article in Zh | MEDLINE | ID: mdl-29224314
Objective: To analyze the clinical value of real-time PCR for virus detection in the diagnosis and treatment of patients after allo-HSCT who had no infection evidence of pneumonia using routine pathogen detection panel. Methods: The clinical data of 71 episodes with acute lung injury from May 2015 to March 2017 after allo-HSCT in hematology department of Peking University People's Hospital (PKUPH) were retrospectively analyzed. PCR for virus detection and other routine pathogen detection tests were performed on bronchoalveolar lavage fluid (BALF) samples. Results: Among 71 episodes with acute lung injury, a total of 15 patients were diagnosed as lower respiratory tract disease merely associated with virus (detection rate of 21.13%) , 19 episodes were absent of lower respiratory tract infection. The median time from allo-HSCT to the occurrence of lung injury were 176 (49-1 376) d and 196 (57-457) d respectively (z=-0.191, P=0.864) . There were no statistical differences for baseline characteristics and clinical features between two groups. The 100-day attributable mortalities were 13.3% (2/15) and 26.3% (5/19) (χ(2)=0.864, P=0.426) . Patients with low-dose steroids treatment had favorable outcome than those with high-dose steroids treatment (the dose of methylprednisolone ≥250 mg/d as standard) [4.2% (1/24) vs 60.0% (6/10) ]. In patients with detectable virus in BALF, 2 patients died with early high-dose steroids treatment, while 11 patients survived with no steroids treatment or late application. Conclusions: Virus infection should be considered in post-HSCT pneumonia patient with negative result using routine pathogen detection panel. Expanding virus detection panel by PCR in BALF could increase diagnostic precision and might be instructive to treatment.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pneumonia / Bronchoalveolar Lavage Fluid / Hematopoietic Stem Cell Transplantation Type of study: Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: Zh Journal: Zhonghua Xue Ye Xue Za Zhi Year: 2017 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Pneumonia / Bronchoalveolar Lavage Fluid / Hematopoietic Stem Cell Transplantation Type of study: Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Humans Language: Zh Journal: Zhonghua Xue Ye Xue Za Zhi Year: 2017 Document type: Article Affiliation country: Country of publication: