Pulmonary Involvement in Patients with Hematological Malignancies

É. Azoulay (ed.), Pulmonary Involvement in Patients with Hematological Malignancies, DOI: 10.1007/978-3-642-15742-4_2, © Springer-Verlag Berlin Heidelberg 2011 Acute pulmonary events are among the most common complications in patients with hematological malignancies. These events often raise difficult diagnostic and therapeutic challenges. In this book, readers faced with these challenges will find a vast array of clinically relevant information contributed by physicians in many specialties who have acquired considerable experience over the years. Pulmonary complications in patients with hematological malignancies may be related to many factors, including infection, tissue invasion by the malignant cells, toxicity and immune deficiency related to the disease or treatments. The multiplicity of the possible etiologies and frequent presence of more than one etiology in a given patient create diagnostic conundrums. Importantly, an early accurate diagnosis is crucial to improve patient outcomes. This book provides practical guidance on untangling complex diagnoses and selecting optimal treatments. In addition to hematologists, intensivists, and pulmonologists, clinicians from many specialties may be called on to manage respiratory events in patients with hematological malignancies. This book was written to serve as an easily accessible source of information to primary-care physicians, emergencyroom physicians, intensivists and physicians working in internal medicine, infectious diseases or pulmonary care departments. Furthermore, the problems encountered in patients with hematological malignancies are relevant to all specialties where patients require immunosuppressant treatments for systemic inflammatory diseases, including clinical immunology, rheumatology, hepatology, gastroenterology, nephrology, dermatology, neurology, and solid organ transplantation. This book has six parts. After an introduction by Dr Soubani, who presents a comprehensive overview of infectious etiologies of respiratory events in patients with hematological malignancies, the first part focuses on epidemiology. International leaders draw attention to important points such as the specificities of bone marrow transplant recipients and the possibility of non-infectious pulmonary involvement, most notably heart failure with pulmonary edema whose diagnostic and therapeutic management differ fundamentally from those of other etiologies of respiratory events in hematological patients. The second part addresses ongoing controversies about the best diagnostic strategies, which are largely fueled by the fast pace at which new diagnostic tools are being introduced. Renowned researchers discuss the latest information on the benefit/risk ratio of diagnostic tools ranging from the least invasive (clinical examination) to the most invasive (surgical lung biopsy). This careful attention to diagnostic tools is warranted, as mortality is higher when no cause to the respiratory symptoms is identified. In patients who are not receiving mechanical ventilation, noninvasive diagnostic testing may provide comparable diagnostic yields to those obtained using bronchoscopy with bronchoalveolar lavage. Attention is drawn to the valuable information that can be derived by the optimal use and interpretation of lung computed tomography. In the third and the fourth parts of this book, leading researchers describe the spectrum of pulmonary infections in hematological patients because of pathogens ranging from common bacteria to opportunistic pathogens, and the spectrum of Pulmonary Involvement in Patients with Hematological Malignancies