Articles |

Inflammatory Mediators in BAL Fluid as Markers of Evolving Pneumonia in Leukocytopenic Patients FREE TO VIEW

Michael G. Kiehl; Helmut Ostermann; Michael Thomas; Traute Birkfellner; Joachim Kienast
Author and Funding Information

From the Department of Internal Medicine, Hematology/Oncology Section, University of Muenster, Germany

1997 by the American College of Chest Physicians

Chest. 1997;112(5):1214-1220. doi:10.1378/chest.112.5.1214
Text Size: A A A
Published online


Study objectives: Pneumonia during chemotherapy-induced leukocytopenia is a major cause of overall treatment failure in patients with hematologic malignancies. To improve outcome in these high-risk patients, early diagnosis of pulmonary infiltrates and institution of adequate antimicrobial treatment are mandatory. To identify patients with evolving pneumonia, we have prospectively studied the prognostic value of cytokine and complement measurements in early BAL samples from febrile leukocytopenic patients.

Design: Prospective, comparative study.

Setting: Hematology/oncology section of a university hospital.

Patients: Twenty-one patients with leukocytopenia (WBC count <1.000/µL) following cytoreductive chemotherapy for malignant disorders.

Intervention: Early BAL sampling primarily for microbiologic diagnostic purposes.

Measurements and results: Proinflammatory cytokines and activated complement components were measured in the BAL aspirates and the results were related to the prevalence or subsequent evolution of overt pneumonia. Of the 21 patients studied, 10 patients presented with overt pneumonia at BAL sampling (group A), 5 patients developed objective signs of pneumonia 3 to 5 days after BAL (group B), and 6 patients remained free of pneumonia during follow-up (group C). In comparison with group C, patients in groups A and B both had distinctly elevated bronchoalveolar levels of tumor necrosis factor-α, interleukin-6, granulocyte colony-stimulating factor, C3a, and C5a.

Conclusions: Cytokine and complement determinations in early BAL samples may aid in the identification of febrile leukocytopenic patients with evolving pneumonia 3 to 5 days prior to the manifestation of diagnostic clinical and radiographic signs.




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543