Safety and usefulness of bronchoscopy in patients with hematological disorders

[Purpose]To evaluate the safety and usefulness of bronchoscopy for post-transplantation pulmonary lesions and/or opportunistic infections in patients with hematological disorders. [Subjects and methods]Between January 2009 and June 2012, 113 patients having hematological disorders with pulmonary lesions underwent bronchoscopy, with 7 patients undergoing it twice and 3 undergoing in thrice. Bronchoscopic procedure and its complications were evaluated. [Results]Eighty-two males and 31 females with a median age of 60 years were included in this study. The underlying disease was acute myelogenous leukemia in 64 patients, malignant lymphoma in 18, acute lymphocytic leukemia in 9, myelodysplastic syndrome in 13, and others in 6. The median blood platelet count was 82,000/μl and 59 patients (52.2%) underwent platelet transfusion a day before or on the day of bronchoscopy. Moreover, before bronchoscopy, 31 patients (27.4%) were administered supplemental oxygen. The bronchoscopic procedures included bronchial washing in 68 patients, bronchoalveolar lavage in 41, and transbronchial lung biopsy in 41. With regard to complications, the respiratory condition deteriorated for more than two days after bronchoscopy in 9 patients (8.0%), and in 4 (3.5%) there was no improvement and the patients died within a month. In addition, 60 patients (53.1%) had post-bronchoscopy treatment changes. [Conclusions]Our result suggest that bronchoscopy is useful in making treatment decisions regarding pulmonary lesions in patients with hematological disorders. However, we recommend that special attention should also be paid toward the patients’ respiratory condition.