Diffuse alveolar hemorrhage as a complication in patients with hematologic malignancies after chemotherapy: report of two cases and literature review.
- Author:
Qian JIANG
1
;
Shen-Miao YANG
;
Bin JIANG
;
Bing-Bing LU
;
Xiao-Jun HUANG
;
De-Bing WANG
Author Information
- Publication Type:Case Reports
- MeSH: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; adverse effects; therapeutic use; Female; Hemorrhage; drug therapy; etiology; Humans; Lymphoma, Non-Hodgkin; drug therapy; Male; Methylprednisolone; therapeutic use; Precursor Cell Lymphoblastic Leukemia-Lymphoma; drug therapy; Pulmonary Alveoli
- From: Chinese Journal of Hematology 2007;28(4):230-234
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo study diffuse alveolar hemorrhage (DAH) in patients with hematologic malignancies after chemotherapy and discuss the possible etiology and appropriate therapy.
METHODSSymptoms, physical examinations, laboratory examination, chest radiographs or computed tomographic (CT) scans, treatments and outcomes of two patients with acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL) each after chemotherapy were presented.
RESULTSBoth of the patients developed cough, progressive dyspnea, a drop of hemoglobin level, hypoxemia and widespread pulmonary infiltrate on chest radiographs or CT scans after chemotherapy. Moreover, case 1 (ALL) had high fever and bloody fluid drained from the intubation of mechanical ventilation, case 2 (NHL) developed continual hemoptysis. They were diagnosed as DAH and improved significantly after intermediate- or high-dose corticosteroid therapy.
CONCLUSIONSDAH is a rare fatal acute noninfectious pulmonary complication in patients with hematologic malignancies after chemotherapy. Early accurate diagnosis, identifying the underlying cause and appropriate treatment are critical for the management of DAH.
