Routine chest radiography for the evaluation of febrile neutropenic patients after autologous stem cell transplantation

Vivek Roy, Lubna I. Ali, George B. Selby

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Chest radiographs are routinely obtained for diagnostic evaluation of neutropenic febrile patients. We investigated the frequency of chest radiographic abnormalities during febrile episodes after autologous PBSC transplants and assessed the relationship of these abnormalities to past history of pulmonary disease, pre-transplant chest radiographic abnormalities, and pulmonary signs or symptoms at time of fever. We also studied the impact of chest radiographic findings on patient management. Sixty-one consecutive adult autologous PBSC transplant recipients were studied. Fifty-two (85%) developed fever, and 20 (38%) of these showed new chest radiographic abnormalities suggestive of pulmonary infection. Patients with pre-transplant chest radiographic abnormalities were more likely to develop additional abnormalities with fever post-transplant. Pulmonary symptoms or signs had low sensitivity or specificity for predicting radiographic abnormalities. Only 40% of patients with pulmonary symptoms or signs had an abnormal chest radiograph. Twenty-six percent of patients with abnormal chest radiographs had no clinical findings suggestive of pulmonary infection. The identification of chest radiographic abnormality did not change empiric antibiotic treatment in any patient. The role of routine chest radiography for diagnostic evaluation of febrile autologous PBSC transplant patients should be re-evaluated. (C) 2000 Wiley-Liss, Inc.

Original languageEnglish (US)
Pages (from-to)170-174
Number of pages5
JournalAmerican Journal of Hematology
Volume64
Issue number3
DOIs
StatePublished - Jul 6 2000
Externally publishedYes

Fingerprint

Stem Cell Transplantation
Radiography
Fever
Thorax
Autografts
Lung
Signs and Symptoms
Transplants
Infection
Lung Diseases
Anti-Bacterial Agents
Sensitivity and Specificity

Keywords

  • BMT
  • Chest radiographs
  • Febrile neutropenia
  • Pulmonary infection

ASJC Scopus subject areas

  • Hematology

Cite this

Routine chest radiography for the evaluation of febrile neutropenic patients after autologous stem cell transplantation. / Roy, Vivek; Ali, Lubna I.; Selby, George B.

In: American Journal of Hematology, Vol. 64, No. 3, 06.07.2000, p. 170-174.

Research output: Contribution to journalArticle

@article{4ed1d72b5e8c4c69ab20b7be305c1a4b,
title = "Routine chest radiography for the evaluation of febrile neutropenic patients after autologous stem cell transplantation",
abstract = "Chest radiographs are routinely obtained for diagnostic evaluation of neutropenic febrile patients. We investigated the frequency of chest radiographic abnormalities during febrile episodes after autologous PBSC transplants and assessed the relationship of these abnormalities to past history of pulmonary disease, pre-transplant chest radiographic abnormalities, and pulmonary signs or symptoms at time of fever. We also studied the impact of chest radiographic findings on patient management. Sixty-one consecutive adult autologous PBSC transplant recipients were studied. Fifty-two (85{\%}) developed fever, and 20 (38{\%}) of these showed new chest radiographic abnormalities suggestive of pulmonary infection. Patients with pre-transplant chest radiographic abnormalities were more likely to develop additional abnormalities with fever post-transplant. Pulmonary symptoms or signs had low sensitivity or specificity for predicting radiographic abnormalities. Only 40{\%} of patients with pulmonary symptoms or signs had an abnormal chest radiograph. Twenty-six percent of patients with abnormal chest radiographs had no clinical findings suggestive of pulmonary infection. The identification of chest radiographic abnormality did not change empiric antibiotic treatment in any patient. The role of routine chest radiography for diagnostic evaluation of febrile autologous PBSC transplant patients should be re-evaluated. (C) 2000 Wiley-Liss, Inc.",
keywords = "BMT, Chest radiographs, Febrile neutropenia, Pulmonary infection",
author = "Vivek Roy and Ali, {Lubna I.} and Selby, {George B.}",
year = "2000",
month = "7",
day = "6",
doi = "10.1002/1096-8652(200007)64:3<170::AID-AJH5>3.0.CO;2-P",
language = "English (US)",
volume = "64",
pages = "170--174",
journal = "American Journal of Hematology",
issn = "0361-8609",
publisher = "Wiley-Liss Inc.",
number = "3",

}

TY - JOUR

T1 - Routine chest radiography for the evaluation of febrile neutropenic patients after autologous stem cell transplantation

AU - Roy, Vivek

AU - Ali, Lubna I.

AU - Selby, George B.

PY - 2000/7/6

Y1 - 2000/7/6

N2 - Chest radiographs are routinely obtained for diagnostic evaluation of neutropenic febrile patients. We investigated the frequency of chest radiographic abnormalities during febrile episodes after autologous PBSC transplants and assessed the relationship of these abnormalities to past history of pulmonary disease, pre-transplant chest radiographic abnormalities, and pulmonary signs or symptoms at time of fever. We also studied the impact of chest radiographic findings on patient management. Sixty-one consecutive adult autologous PBSC transplant recipients were studied. Fifty-two (85%) developed fever, and 20 (38%) of these showed new chest radiographic abnormalities suggestive of pulmonary infection. Patients with pre-transplant chest radiographic abnormalities were more likely to develop additional abnormalities with fever post-transplant. Pulmonary symptoms or signs had low sensitivity or specificity for predicting radiographic abnormalities. Only 40% of patients with pulmonary symptoms or signs had an abnormal chest radiograph. Twenty-six percent of patients with abnormal chest radiographs had no clinical findings suggestive of pulmonary infection. The identification of chest radiographic abnormality did not change empiric antibiotic treatment in any patient. The role of routine chest radiography for diagnostic evaluation of febrile autologous PBSC transplant patients should be re-evaluated. (C) 2000 Wiley-Liss, Inc.

AB - Chest radiographs are routinely obtained for diagnostic evaluation of neutropenic febrile patients. We investigated the frequency of chest radiographic abnormalities during febrile episodes after autologous PBSC transplants and assessed the relationship of these abnormalities to past history of pulmonary disease, pre-transplant chest radiographic abnormalities, and pulmonary signs or symptoms at time of fever. We also studied the impact of chest radiographic findings on patient management. Sixty-one consecutive adult autologous PBSC transplant recipients were studied. Fifty-two (85%) developed fever, and 20 (38%) of these showed new chest radiographic abnormalities suggestive of pulmonary infection. Patients with pre-transplant chest radiographic abnormalities were more likely to develop additional abnormalities with fever post-transplant. Pulmonary symptoms or signs had low sensitivity or specificity for predicting radiographic abnormalities. Only 40% of patients with pulmonary symptoms or signs had an abnormal chest radiograph. Twenty-six percent of patients with abnormal chest radiographs had no clinical findings suggestive of pulmonary infection. The identification of chest radiographic abnormality did not change empiric antibiotic treatment in any patient. The role of routine chest radiography for diagnostic evaluation of febrile autologous PBSC transplant patients should be re-evaluated. (C) 2000 Wiley-Liss, Inc.

KW - BMT

KW - Chest radiographs

KW - Febrile neutropenia

KW - Pulmonary infection

UR - http://www.scopus.com/inward/record.url?scp=0034084869&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034084869&partnerID=8YFLogxK

U2 - 10.1002/1096-8652(200007)64:3<170::AID-AJH5>3.0.CO;2-P

DO - 10.1002/1096-8652(200007)64:3<170::AID-AJH5>3.0.CO;2-P

M3 - Article

C2 - 10861811

AN - SCOPUS:0034084869

VL - 64

SP - 170

EP - 174

JO - American Journal of Hematology

JF - American Journal of Hematology

SN - 0361-8609

IS - 3

ER -