Pulmonary Hemorrhage in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Single-Center Retrospective Study

• Published in: Pediatric critical care medicine Vol. 25; no. 1; p. e47
• Main Authors: Chopra, Yogi, Alsabahi, Amal, Schechter, Tal, Mtaweh, Haifa, Sweezey, Neil, Balit, Corinne, Ali, Muhammad, Chiang, Kuang-Yueh, Gassas, Adam, Krueger, Joerg
• Format: Journal Article
• Language: English
• Published: United States 01.01.2024
• Subjects: Child; Hematopoietic Stem Cell Transplantation - adverse effects; Humans; Retrospective Studies; Risk Factors; Stem Cell Transplantation
• ISSN: 1529-7535
• DOI: 10.1097/PCC.0000000000003350

Pulmonary hemorrhage (PH) is a serious complication posthematopoietic stem cell transplant (HSCT). In view of limited available pediatric data, we performed a retrospective study to describe epidemiology, management, and outcomes of PH post-HSCT in children in our national center. Retrospective study. Academic children's hospital (2000-2015). Children (< 18 yr) with PH and requiring PICU care post-HSCT. None. The historical prevalence of PH in our center was 2.7% (31/1,148). Twenty patients had a concomitant infection, 15 had bacterial infection, 8 had viral infection, and 3 patients had a fungal infection. With a median follow-up time of 60 months, 7 of 31 patients were alive. Early PH (< 40 d post-HSCT) was associated with improved survival (6/15 vs 1/16, p = 0.035). Patients who received high-dose pulsed corticosteroid had improved survival when compared with those who did not (7/22 vs 0/9, p = 0.0012); this also applied to the subgroup of patients with a concomitant infection (5/15 vs 0, p = 0.001). None of the patients who survived had measurable respiratory sequelae. PH is a rare but serious complication after HSCT. Corticosteroids were associated with improved survival even in patients with a concomitant infection.