Impact of open lung biopsy for undiagnosed pulmonary infiltrates in patients with hematological malignancies

Pulmonary complications are frequently encountered in patients with hematol ogical malignancy. The optimal therapeutic decision including open lung bio psy (OLB) for such patients is uncertain. We herein examine the clinical im pact of OLB on these patients. Seven patients with progressively diffuse pu lmonary infiltrates despite aggressive medical treatment were examined. The underlying diseases, prior treatment for presumptive pneumonia, the change in therapeutic approach after operation, and clinical outcome were reviewe d retrospectively. Diffuse pulmonary infiltrates were caused by infection i n two patients and by noninfectious etiology such as alveolar proteinosis, idiopathic interstitial pneumonitis, leukemic involvement, and drug-induced alveolar damage in the others. Four patients who had serious underlying he matologic diseases such as myelodysplastic syndrome, acute and chronic myel oid leukemia, and T cell lymphoma died. Three patients with acute lymphoid leukemia survived. In two of these three, change of therapeutic strategies after OLB was created for the survival. OLB in patients with hematological malignancy may be useful in selected patients with a treatable hematologic disease who have treatable underlying causes of the pulmonary infiltrate. A m. J. Hematol. 68:87-90, 2001. (C) 2001 Wiley-Liss, Inc.