Open lung biopsy (OLB) to diagnose pulmonary complications (PC) after high dose chemotherapy (HDC) and allogeneic stem cell transplant (ASCT)

6646 Background: HDC and ASCT often lead to infectious and non-infectious PC. Non-infectious PC includes interstitial pneumonitis, bronchiolitis obliterans (BO), BO with organizing pneumonia (BOOP), and diffuse alveolar hemorrhage. Patients (pts.) often undergo bronchoscopy with bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) to establish a diagnosis. It is unclear if BAL and TBB establish a firm diagnosis or alter therapy. The purpose of this study was to examine the safety, diagnostic yield, and the ability of OLB to influence therapy in pts. with PC after HDC and ASCT. Methods: Out of 180 patients who underwent HDC and ASCT from April 1998 to February 2003, 10 underwent an OLB. Results: In these 10 pts.,14 bronchoscopies were done prior to OLB. All pts. except 2 had at least 1 bronchoscopy, 2 pts. had 2 bronchoscopies, and 2 pts. had 3 bronchoscopies. From these 14 BAL's an infectious etiology was found in 3 (21%). In addition, 8 TBB were done in 6 pts., with 1 patient undergoing 3 TBB. 4 ...