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Transfusion-Related Acute Lung Injury in Children with Hematological Malignancies

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Pulmonary Involvement in Patients with Hematological Malignancies

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Abstract

Although uncommon, acute lung injury (ALI) and its more severe form the acute respiratory distress syndrome (ARDS) are serious life-threatening complications that may occur during the routine treatment of children with hematological malignancies. ALI may be the results of both the treatment of the malignancy or an adverse event related to supportive care, especially transfusion. Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion-related morbidity and mortality worldwide and has been described in a number of children with hematological malignancies. The following chapter introduces ALI/ARDS, describes clinical TRALI and its pathogenesis, and outlines other causes of ALI in this patient population that must be excluded. Mitigation strategies to avoid TRALI are also included.

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Abbreviations

ALI:

Acute lung injury

AML:

Acute myelocytic leukemia

ANC:

Absolute neutrophil count

APML:

Acute promyelocytic leukemia

ARDS:

Acute respiratory distress syndrome

EASTR:

Epidemiology and survival of transfusion recipients

EC:

Endothelial cells

ECMO:

Extracorporeal membrane oxygenation

GI:

Gastrointestinal

GM-CSF:

Granulocyte monocyte colony-stimulating factor

HLA:

Human leukocyte antigen

HMVECs:

Human microvascular endothelial cells

HNA:

Human neutrophil antigen

LTB4 :

Leukotriene B4

MHC:

Major histocompatablity complex

PRBCs:

Packed red blood cells

SHOT:

Serious hazards of transfusion

TRALI:

Transfusion-related acute lung injury

VEGF:

Vascular endothelial growth factor

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Acknowledgments This work was supported by Bonfils Blood Center, The Department of Pediatrics, School of Medicine, University of Colorado Denver, Aurora, CO, and grant GM49222 from NIGMS, NIH.

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Authors and Affiliations

  1. Departments of Pediatrics, School of Medicine, University of Colorado Denver, Aurora, CO, USA

    Rachel S. Bercovitz

  2. Bonfils Blood Center, Denver, CO, USA

    J. Bradley Ball, Marguerite R. Kelher & Christopher C. Silliman

  3. Departments of Pediatrics and Surgery, School of Medicine, University of Colorado Denver, Aurora, CO, USA

    J. Bradley Ball & Marguerite R. Kelher

  4. Research Department, Bonfils Blood Center, 717 Yosemite Street, Denver, CO, 80230, USA

    Christopher C. Silliman

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  1. Rachel S. Bercovitz
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  2. J. Bradley Ball
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  3. Marguerite R. Kelher
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  4. Christopher C. Silliman
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Corresponding author

Correspondence to Christopher C. Silliman .

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  1. Service de Réanimation Médicale, Hôpital Saint Louis, Avenue Claude Vellefaux 1, Paris, 75010, France

    Elie Azoulay

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Bercovitz, R.S., Ball, J.B., Kelher, M.R., Silliman, C.C. (2011). Transfusion-Related Acute Lung Injury in Children with Hematological Malignancies. In: Azoulay, E. (eds) Pulmonary Involvement in Patients with Hematological Malignancies. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-15742-4_35

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  • DOI: https://doi.org/10.1007/978-3-642-15742-4_35

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