Outcome of patients with hematologic malignancies and pulmonary infiltrates requiring flexible bronchoscopy

This retrospective chart review study was undertaken to describe the outcome of patients with hematologic malignancies (HM) and bone-marrow transplant recipients with pulmonary infiltrates undergoing flexible bronchoscopy in a primary and tertiary care university-affiliated medical center. A total of 137 consecutive patients were seen from May 2000 to May 2002, 70% bone-marrow transplant recipients and 30% with HM, developed pulmonary infiltrates (diffuse, 76%; neutropenic, 51.8%). Clinical variables were recorded and predictors of adverse outcome were investigated. Overall, 27.7% of the patients required mechanical ventilation. Forty-seven (34.3%) patients died, 87% from respiratory and multiorgan failure. In a uni-variate analysis, male sex (P=0.026), mechanical ventilation (P=0.006), and multiorgan failure (P<0.0001) were associated with increased risk of death. The data may serve to help plan pulmonary and ICU services in institutes treating patients with HM.