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Inicio Medicina Clínica (English Edition) Usefulness of bronchoalveolar lavage and flow cytometry in patients with hematol...
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Vol. 148. Issue 7.
Pages 297-302 (April 2017)
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Vol. 148. Issue 7.
Pages 297-302 (April 2017)
Original article
DOI: 10.1016/j.medcle.2016.10.056
Usefulness of bronchoalveolar lavage and flow cytometry in patients with hematological malignancies and respiratory failure
Utilidad del lavado broncoalveolar y la citometría de flujo en pacientes con hemopatías malignas e insuficiencia respiratoria
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Christelle Ferràa,b, Blanca Xicoya,b,
Corresponding author
bxicoy@iconcologia.net

Corresponding author.
, Nerea Castilloa, Mireia Morgadesa, Jordi Juncàb, Felipe Andreoc, Fuensanta Milláa,b, Evarist Feliua,b, Josep-María Riberaa,b
a Servicio de Hematología, Institut Català d’Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain
b Instituto de Investigación contra la Leucemia Josep Carreras, Badalona, Universitat Autònoma de Barcelona, Barcelona, Spain
c Servicio de Neumología, Hospital Germans Trias i Pujol, Badalona, Spain
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Table 1. Clinical characteristics of the 70 patients included in the study.
Abstract
Background and objectives

Strategies to improve the efficiency of bronchoalveolar lavage (BAL) are needed. We conducted a study to establish the diagnostic value of BAL in patients with hematological malignancies and pulmonary infiltrates.

Patients and methods

The correlation of cytologic and flow cytometric study of BAL with the microbiological findings and the clinical evolution was determined.

Results

Seventy BAL were performed and flow cytometric study was analyzed in 23 of them. Fifty-three patients did not present any adverse event attributable to BAL. Anti-infectious therapy was modified in 64 (91%) patients. T lymphocyte count >0.3×109/L in peripheral blood was associated with longer OS at 3 years (53 vs. 22%, p=0.009). Higher CD4 (>20/μL) and CD8 (>35/μL) lymphocyte counts in the BAL were associated with a longer OS at 3 years: 82 vs. 21% (p=0.030) and 80 vs. 23% (p=0.059).

Conclusions

Our study confirms the clinical value of BAL for treatment decision making in patients with hematological malignancies and acute respiratory failure.

Keywords:
Bronchoalveolar lavage
Flow cytometry
Respiratory failure
Hematological malignancies
Resumen
Antecedentes y objetivo

Para mejorar la eficiencia del lavado broncoalveolar (LBA) son necesarias nuevas estrategias. Con esta finalidad se desarrolló un estudio para establecer el valor diagnóstico del LBA en pacientes con hemopatías malignas e infiltrados pulmonares.

Pacientes y método

Se analizó la correlación del estudio citológico y la citometría de flujo del LBA con los hallazgos microbiológicos y la evolución clínica.

Resultados

Se analizaron setenta LBA y se realizó estudio de citometría de flujo en 23 de ellos. Cincuenta y tres pacientes no presentaron ningún efecto adverso atribuible al LBA. Se modificó el tratamiento antiinfeccioso en 64 (un 91%) de los pacientes. La cifra de linfocitos T >0,3×109/L en sangre periférica se asoció a una mayor supervivencia global a los 3 años (el 53 vs. 22%, p=0,009). Una cifra más elevada de linfocitos T CD4 (>20/μL) y CD8 (>35/μL) en el LBA se asoció a una mayor supervivencia global a los 3 años: el 82 vs. 21% (p=0,030) y el 80 vs. 23% (p=0,059).

Conclusiones

Nuestro estudio confirma el valor clínico del LBA en la estrategia terapéutica de pacientes con hemopatías malignas e insuficiencia respiratoria.

Palabras clave:
Lavado broncoalveolar
Citometría de flujo
Insuficiencia respiratoria
Hemopatías malignas

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