title: Early Lung Computed Tomography Scan after Allogeneic Hematopoietic Stem Cell Transplantation.
abstract: A lung computed tomography (CT) scan is essential for diagnosing lung diseases in hematopoietic stem cell transplantation (HSCT) recipients. As a result, lung CT scans are increasingly prescribed in the early phase after allogeneic HSCT, with no assessment of the added value for global patient management. Among 250 patients who underwent allogeneic HSCT in our center over a 2-year period, we evaluated 68 patients who had at least 1 lung CT scan within the first 30 days post-transplantation. The median interval between allogeneic HSCT and lung CT scan was 8.5 days. Patients who underwent an early lung CT scan were more immunocompromised and had a more severe course. Fever was the main indication for the CT scan (78%). The lung CT scan was abnormal in 52 patients, including 17 patients who had an abnormal pre-HSCT CT scan. A therapeutic change was noted in 37 patients (54%) within 24 hours after the lung CT scan. The main changes included the introduction of corticosteroids (n = 23; 62%), especially in patients with a normal CT scan (89%). In univariate models, we found that a normal pretransplantation CT scan (P = .002), the absence of either dyspnea (P = .029) or hypoxemia (P = .015), and a serum C-reactive protein level <10 mg/L (P = .004) were associated with a normal post-HSCT lung CT scan. We found that the association of these variables could predict the normality of early post-HSCT lung CT scans. Pretransplantation lung CT scans are useful for the interpretation of subsequent lung CT scans following allogeneic HSCT, which are frequently abnormal. Early post-HSCT lung CT scans are helpful in patient management, but prescriptions could be more targeted.
authors.affiliation: Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France.
authors.forename: Marie Alice
authors.initials: MA
authors.lastname: Cornetto
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France; Service de Biostatistique et Information Médicale AP-HP, Hôpital Saint-Louis, Paris, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Chevret
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France; Service de Pneumologie, CHU Nantes, Nantes, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Abbes
authors.affiliation: Service de Radiologie, AP-HP, Hôpital Saint-Louis, Paris, France.
authors.forename: Constance
authors.initials: C
authors.lastname: de Margerie-Mellon
authors.affiliation: Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Hussenet
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France.
authors.forename: Flore
authors.initials: F
authors.lastname: Sicre de Fontbrune
authors.affiliation: Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France.
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Tazi
authors.affiliation: Univ Paris Diderot, Sorbonne Paris Cité; AP-HP, Hématologie-Greffe, Hôpital Saint-Louis, Paris, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ribaud
authors.affiliation: Service de Pneumologie, AP-HP, Hôpital Saint-Louis, Paris, France; Univ Paris Diderot, Sorbonne Paris Cité, UMR1153 CRESS, Biostatistics and Clinical Epidemiology Research Team, Paris, France. Electronic address: anne.bergeron-lafaurie@aphp.fr.
authors.forename: Anne
authors.initials: A
authors.lastname: Bergeron
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D042241:Early Diagnosis; D005260:Female; D005334:Fever; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Lung complications; Management strategy