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Master Thesis

Apport de la fibroscopie bronchique en hématologie : étude prospective monocentrique

Abstract : Introduction. Over the past decade, outcome of patients with hematological diseases has been improved through new intensive treatment regimens. Intensive care has also increased the risk of infectious diseases, which are a major cause of morbidity and mortality for these patients. An important prognostic factor is the time to introduce effective treatment. Microbiological identification can sometimes be difficult and delay the introduction of effective treatment. In this study, we evaluated the interest of bronchoscopy and bronchoalveolar lavage (BAL) in hematological patients with dyspnea. Methods. We prospectively included all patients followed up for hematological malignancies at the Grenoble-Alpes University Hospital who underwent bronchoscopy for dyspnea between October 2019 and October 2020. Demographic, clinical and radiological characteristics of these patients are collected. We present the usefulness of invasive respiratory sampling in the diagnostic and therapeutic strategies. We also evaluated the impact of pneumopathy on survival and the continuation of hematological treatment. Results. A total of fifty bronchoscopy, performed in 44 patients, were collected. Among these patients, twenty-one had acute myeloid leukemia and sixteen received an allogeneic stem cell transplantation (HSCT), ten of them within 100 days of the respiratory episode. A diagnosis was made for 38 pneumopathies, 34 of which were of infectious origin. Invasive respiratory samples combined with non-invasive examinations allowed a diagnosis for 27 pneumopathies (23 infectious and 4 non-infectious). Eighteen cases of pneumonia were diagnosed based on BAL alone (17 infectious and 1 non-infectious). Therapeutic modification following BAL was noted for 31 pneumopathies (62%). Conclusion. For patient suffered from hematological malignancies associated with pneumonia, bronchoscopy plays an important role in diagnostic and therapeutic strategies.
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Master Thesis
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Contributor : Jean-Hugues Morneau Connect in order to contact the contributor
Submitted on : Friday, June 18, 2021 - 12:08:37 PM
Last modification on : Wednesday, June 23, 2021 - 3:22:22 AM
Long-term archiving on: : Sunday, September 19, 2021 - 6:30:06 PM


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  • HAL Id : dumas-03264533, version 1
  • PPN : 256063729


Salomé Gallet. Apport de la fibroscopie bronchique en hématologie : étude prospective monocentrique. Médecine humaine et pathologie. 2021. ⟨dumas-03264533⟩



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