Radiological Characterization of Pulmonary Involvement in Patients With Hematological Diseases

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

148 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-09-27

Study Completion Date

2025-11-21

Brief Summary

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Hematologic malignancies are heterogeneous groups of neoplasia, with frequent pulmonary complications. These complications may be secondary to the patient's comorbidities, to the hemopathy itself, or its treatments. Divided into infectious and non-infectious complications, the etiologies are numerous and varied. This makes the diagnostic approach complex for the clinicians

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Detailed Description

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Although infectious processes of the lungs are common in these immunosuppressed patient collectives, non-infectious causes account for up to half of the pulmonary manifestations found in hematologic malignancies. Besides the frequent infections including opportunistic pathogens, a broad differential diagnosis including drug-induced lung injury by cytostatic substances, cytokines, and innovative immunotherapeutic agents, rarer transfusion of blood products, and intrathoracic manifestations of the hematologic malignancy itself, must be kept in mind. Finally, vascular complications can also lead to pulmonary reactions. Early and consistent diagnostics and treatment of bronchopulmonary, intrathoracic, and vascular complications within the framework of hematologic systemic diseases can be essential for the patient's prognosis. Up to 25% of patients with profound neutropenia lasting for \>10 days develop lung infiltrates, which frequently do not respond to broad-spectrum antibacterial therapy. While a causative pathogen remains undetected in most cases, Aspergillus spp., Pneumocystis jirovecii, multi-resistant Gram-negative pathogens, mycobacteria or respiratory viruses may be involved. In at-risk patients who have received trimethoprim-sulfamethoxazole (TMP/SMX) prophylaxis, filamentous fungal pathogens appear to be predominant, yet commonly not proven at the time of treatment initiation.

In patients who do not improve rapidly with first-line therapy with broad spectrum antibiotics, cross-sectional thoracic CT imaging is essential. It provides much better definition of the pattern of radiological changes that includes three main groups: consolidation, nodules (micro- and macro-), and diffuse changes, as ground glass pattern. Discuss these radiological patterns and how this guides the appropriate initial investigations and treatment options will be of a great value to be followed.

Conditions

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Hematologic Diseases

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

RETROSPECTIVE

Study Groups

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1

patient admitted with hematological disease and pulmonary manifestations

Complete Blood Count

Intervention Type DIAGNOSTIC_TEST

blood sample

C-reactive protein

Intervention Type DIAGNOSTIC_TEST

serum sample

O2 saturation

Intervention Type DIAGNOSTIC_TEST

blood sample

Serum ferritin and D-dimer

Intervention Type DIAGNOSTIC_TEST

Blood sample

Liver and renal function tests

Intervention Type DIAGNOSTIC_TEST

Blood sample

Lactate dehydrogenase

Intervention Type DIAGNOSTIC_TEST

Blood sample

coronavirus (SARS-CoV-2) swab

Intervention Type DIAGNOSTIC_TEST

Throat swab

CT chest

Intervention Type RADIATION

Radiation

Interventions

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Complete Blood Count

blood sample

Intervention Type DIAGNOSTIC_TEST

C-reactive protein

serum sample

Intervention Type DIAGNOSTIC_TEST

O2 saturation

blood sample

Intervention Type DIAGNOSTIC_TEST

Serum ferritin and D-dimer

Blood sample

Intervention Type DIAGNOSTIC_TEST

Liver and renal function tests

Blood sample

Intervention Type DIAGNOSTIC_TEST

Lactate dehydrogenase

Blood sample

Intervention Type DIAGNOSTIC_TEST

coronavirus (SARS-CoV-2) swab

Throat swab

Intervention Type DIAGNOSTIC_TEST

CT chest

Radiation

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* All patients aged 18 years or older diagnosed with hematological diseases and documented pulmonary manifestations during their disease course

Exclusion Criteria

1. Patients aged under 18 years.
2. Patients without demonstrable evidence of lung involvement.
3. Patients with incomplete medical records or insufficient data to analyze.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No