Birgitta Versluijs

88 Results TABLE 3. Results from screening tests in BAL before HCT. Test Viral PCR N=113 Bacterial culture N=123 Fungal culture N=123 GM* N=119 No positive (%) 35 (31) 22 (17) 8 (7)† 21 (18) 17 (14) Rhinovirus, 18 RSV, 3 Influenzavirus, 2 Coronavirus, 2 Adenovirus, 2 Bocavirus, 1 Metapneumovirus, 1 Parainfluenzavirus, 1 Mixed viruses, 5 H. influenzae, 7 Streptococci, 3 Mycoplasma Pn, 1 Pseudomonas, 1 Stenotrophomonas, 1 Klebsiella, 1 Mixed, 7 Candida spp, 2 Aspergillus spp, 3 Penicillium spp, 3 * Galactomannan (GM) in bronchoalveolar lavage (BAL), > .5 = positive. † There was overlap between fungal culture results and galactomannan findings in BAL (2 of 3 Aspergillus-positive patients were also galactomannan positive, 1 patient with Candida and 1 with Penicillium also had positive GM) so 21 patients were considered positive for fungus. and in 2 patients we gave granulocyte transfusions during the period of neutropenia. One patient had graft rejection and showed fatal progression of Aspergillus infection in prolonged neutropenia. The 3 others did not show progression of infection, and therapy could be stopped safely after engraftment. No patient with RV or bacteria isolated showed progression of pulmonary infection during HCT. None of the patients with isolated positive findings for fungus from BAL, of whom the majority received intensification of fungal prophylaxis/treatment, developed pulmonary fungal disease. Cox regression analysis did not show a relation between pre-HCT screening findings in BAL or PFT and symptomatic lung injury after HCT. A clinically significant abnormality on chest HRCT before HCT, however, was a predictor for the development of immune- mediated lung injury after HCT (hazard ratio, 3.49; 95% confidence interval, 1.07 to 11.35; P = .037). 5