Usefulness of bronchoalveolar lavage and flow cytometry in patients with hematological malignancies and respiratory failure. / Utilidad del lavado broncoalveolar y la citometría de flujo en pacientes con hemopatías malignas e insuficiencia respiratoria.

ABSTRACT

BACKGROUND AND OBJECTIVES: Strategies to improve the efficiency of bronchoalveolar lavage (BAL) are needed. We conducted a study to establish the diagnostic value of BAL in patients with hematological malignancies and pulmonary infiltrates. PATIENTS AND METHODS: The correlation of cytologic and flow cytometric study of BAL with the microbiological findings and the clinical evolution was determined. RESULTS: Seventy BAL were performed and flow cytometric study was analyzed in 23 of them. Fifty-three patients did not present any adverse event attributable to BAL. Anti-infectious therapy was modified in 64 (91%) patients. T lymphocyte count >0.3×109/l in peripheral blood was associated with longer OS at 3 years (53 vs. 22%, p=.009). Higher CD4 (>20/µL) and CD8 (>35/µL) lymphocyte counts in the BAL were associated with a longer OS at 3 years 82 vs. 21% (p=.030) and 80 vs. 23% (p=.059). CONCLUSIONS: Our study confirms the clinical value of BAL for treatment decision making in patients with hematological malignancies and acute respiratory failure.