title: Pleural effusions in acute and chronic leukemia and myelodysplastic syndrome.
abstract: OBJECTIVE
  Pulmonary manifestations have been well described in leukemia, but pleural disease is less common. This review highlights pleural effusions in acute and chronic leukemia and myelodysplastic syndrome (MDS) based on the evidence to date. Diagnostic workup and recommendations for the management of these effusions are also outlined.
  
  
  RESULTS
  Pleural effusions in patients with leukemia are most often due to infection and to a lesser extent leukemic infiltration of the pleura. The prognostic implications of these effusions are unclear, but survival is most likely determined by the underlying malignancy and its response to treatment. New therapies have changed survival in these patients, and some of these treatments, such as tyrosine kinase inhibitors, have emerged as important causes for these effusions. Pleural interventions may be accomplished with few complications.
  
  
  CONCLUSIONS
  Pleural effusions may occur with acute and chronic leukemia and MDS. Infection remains the most common cause. Malignant pleural effusions tend to occur in advanced disease in chronic leukemia, but they can be seen at any time with acute leukemia and MDS. With standard precautions, pleural procedures may be performed safely in this population. In cases of unclear cause, pleural and bone marrow biopsy should be considered.
authors.affiliation: aDepartment of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center bDivisions of Critical Care, Pulmonary and Sleep Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
authors.forename: Saadia A
authors.initials: SA
authors.lastname: Faiz
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sahay
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Jimenez
mesh_terms: D000208:Acute Disease; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D002908:Chronic Disease; D000069439:Dasatinib; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000473:pathology*; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000473:pathology*; D010994:Pleura / Q000473:pathology; D010996:Pleural Effusion / Q000139:chemically induced / Q000209:etiology* / Q000473:pathology*; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000009:adverse effects; D013844:Thiazoles / Q000009:adverse effects
chemical_list: D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D000069439:Dasatinib