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Rhee CK et al. – Neutropenia recovery may be associated with deterioration in oxygenation and exacerbation of pre–existing pulmonary disease. However, risk factors for acute respiratory distress syndrome (ARDS) during neutropenia recovery in patients with hematologic malignancies have not been studied. Patients with hematologic malignancies complicated by pneumonia during neutropenia are at increased risk for ARDS during neutropenia recovery.

Exclusive Author Commentary
Jeong Sup Song, 11/08/09

The nature of neutropenia recovery in patients with hematologic malignancies is very different from that in patients with solid cancers. In the present study, we showed differences between patients who developed ARDS during neutropenia and who did not. Among these differences, the occurrence of pneumonia during neutropenia was a strong risk factor for developing ARDS. In patients with hematologic malignancies who have pneumonia during neutropenia, close monitoring of respiratory status during neutropenia recovery is very important. Because the mortality of ARDS patiets in this subset was very high, when pulmonary infiltrate is noted and respiratory symptoms exist before neutropenia recovery, early respiratory care should be offered.


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