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Quadro Pulmonar na fase Inicial Pós-TMO NON INFECTIOUS DISEASES…
Quadro Pulmonar na fase Inicial Pós-TMO NON INFECTIOUS DISEASES
Edema Pulmonar
Large volumes of fluid are frequently
Transfusion
medications, and parenteral nutrition are other
. Hypoalbuminemia
and subsequent development of chemotherapyinduced cardiac dysfunction and/or renal failure
Transfusion-Related Lung Injury
IDIOPATHIC PNEUMONIA SYNDROME
Clinica aguda de dispneia, hipoxemia, infiltrado em RX
Manejo Broncoscopia:
Seo S, Renaud C, Kuypers JM, et al. Idiopathic pneumonia syndrome after hematopoietic cell transplantation: evidence of occult infectious etiologies Blood 2015;125(24):3789–97.
57% dos SPI tinham causa infecciosa
The most frequent pathogens were human herpesvirus-6 (HHV-6) (N = 20 [29%]) followed by human rhinovirus (HRV), cytomegalovirus (CMV), and Aspergillus (N = 8 [12%] in each).
Achados Patológicos
Semelhante a SARA
Pneumonite intersticial e lesão difusa alveolar
Mortalidade excede 60%
Atinge cerca de 2-10% dos TMO's.
12 days to as long as 76 days
Risk Factors
use of a high-dose conditioning regimen, TBI
presence of high-grade acute GVHD in allogeneic recipients,
and physiologic evidence of lung disease before
older age
TNF-alfa
Tratamento
CTC é ineficaz
etanercept?
extracorporeal life support (ECLS) h
DIFFUSE ALVEOLAR HEMORRHAGE
PERI-ENGRAFTMENT RESPIRATORY DISTRESS
SYNDROME
PERDS describes a form of acute lung injury that
occurs around the time of engraftment (typically
within 5 days) and is the pulmonary manifestation
of a diffuse systemic capillary leak disorder termed
the engraftment syndrome (ES).
DRUG-INDUCED PNEUMONITIS
day 100
migratory alveolar
In a report from the Mayo
Clinic of 5340 allogeneic transplantations between
1976 and 1998, 49 cases of COP were identified
by surgical lung biopsy. In contrast, only 2 cases
were seen in the 1183 patients who underwent
autologous transplantation.94
CRYPTOGENIC ORGANIZING PNEUMONIA
ACUTE FIBRINOUS AND ORGANIZING
PNEUMONIA
