Bronchoalveolar lavage in the diagnosis of pulmonary complications of bonemarrow transplant patients

Bronchoalveolar lavage (BAL) has proved valuable in the diagnosis of pulmon ary complications in immunosuppressed patients. We evaluated the diagnostic yield of BAL in pulmonary complications in bone marrow transplantation (BM T) recipients. We reviewed sequentially the records of 89 patients during a n 18-month period. BAL was diagnostic in 42 patients (47%). The most common pulmonary complication diagnosed by BAL was diffuse alveolar hemorrhage (n = 15); followed by bacterial pneumonia (n = 10), respiratory syncytial vir us (n = 8), aspergillosis (n = 6). Pneumocystis carinii pneumonia (n = 5), cytomegalovirus (CMV) (n = 4), and others (n = 4). The final diagnoses in t he BAL nondiagnostic group were: bacterial pneumonia (n = 6), CMV (n = 6), idiopathic pneumonia syndrome (n = 5), cancer recurrence (n = 4), cardiogen ic pulmonary edema (n = 4), and others (n = 9).We conclude that BAL is a us eful diagnostic tool in BMT-related pulmonary complications.