Bronchoalveolar Lavage Fluid, Lung Infection
Conditions
Keywords
Idiopathic Pneumonia Syndrome, CMV Pneumonia, Pneumocystis Jiroveci Pneumonia, Invasive Pulmonary Aspergillosis
Brief summary
The aim of this study was to evaluate the diagnostic yield for lung complication after allo-HSCT by multiple parameter system through BAL.
Detailed description
一) Adult patients with hematology disease under allo-HSCT at any phase of treatment are enrolled according to the following criteria: 1. lung infiltration detection at computed tomography (CT) scan. 2. Patients with fever, cough, respiratory symptoms. According to the investigators, the patients fulfilling these criteria undergo BAL as soon as possible 二) The BALF samples were tested using such methods 1. classic microbiological cultures designed for bacteria, fungi, and mycobacteria. 2. Detection of human cytomegalovirus (CMV) and EB virus in serum and BAL was tested using a Real-time PCR kit. 3. Detection of aspergillus galactomannan antigen 1,3-beta-D-glucan in serum and BAL was performed using an enzyme immunoassay method. 4. Cytological and pathogenic microscopic evaluation in BALF 5. Flow cytological analysis of T lymphocyte subsets in BALF and serum 6. Cytokine detection in BALF and serum 7. Microbiology detection in BALF by mNGS 三) Pathogenic spectrum analysis and Targeted etiological therapy
Interventions
DIAGNOSTIC_TESTBronchoscopic Alveolar Lavage
The diagnostic yield of different diagnostic methods for lung infection and non-infectious diseases under allo-HSCT patients. 1. Classic microbiological cultures designed for bacteria, fungi, and mycobacteria. 2. Detection of human cytomegalovirus (CMV) and EB virus in serum and BAL was tested using a Real-time PCR kit. 3. Detection of aspergillus galactomannan antigen 1,3-beta-D-glucan in serum and BAL was performed using an enzyme immunoassay method. 4. Cytological and pathogenic microscopic evaluation in BALF 5. Flow cytological analysis of T lymphocyte subsets in BALF and serum 6. Cytokine detection in BALF and serum 7. Microbiology detection in BALF by mNGS
Sponsors
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. Diagnosed with hematological diseases. 2. Recipients of allogeneic peripheral blood stem cell transplantation. 3. Lung infiltration detection at computed tomography (CT) scan. 4. Patients with fever, cough, respiratory symptoms. 5. Consent to BAL and follow-up observation after BAL
Exclusion criteria
1. Severe bleeding tendency, platelet less than 20000/uL, or severe coagulation dysfunction; 2. Multiple bullae are at risk of rupture; 3. Untreated patients with active pulmonary tuberculosis; 4. Patients with severe consumptive diseases or conditions and various causes can not cooperate well 5. Cardiac insufficiency, severe pulmonary ventilation dysfunction 6. Recent massive hemoptysis 7. Aortic aneurysm and esophageal varices are at risk of rupture
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| overall response rate | 100 days after BAL | Efficiency of treatment for pulmonary complications after allo-HSCT |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| microbiology diagnostic yields | 100 days after BAL | Comparing the pathogenic detection rate by BALF with non-invasive detection method |
| all-cause mortality and attributable mortality of pulmonary complications | 30-day and 100-day after BAL | 30-day and 100-day mortality (including all-cause mortality and attributable mortality of pulmonary complications) in patients undergoing BAL |
Contacts
Primary Contactxianmin song, M.D.
Backup Contactsu li
Outcome results
None listed