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Review
. 2022 Sep 3;58(9):1215.
doi: 10.3390/medicina58091215.

What Is Different in Acute Hematologic Malignancy-Associated ARDS? An Overview of the Literature

Mihail Cotorogea-Simion  1 , Bogdan Pavel  2 , Sebastian Isac  1   2 , Teodora Telecan  3   4 , Irina-Mihaela Matache  2 , Anca Bobirca  5 , Florin-Teodor Bobirca  6 , Razvan Rababoc  7 , Gabriela Droc  1
Affiliations
Review

What Is Different in Acute Hematologic Malignancy-Associated ARDS? An Overview of the Literature

Mihail Cotorogea-Simion et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Acute hematologic malignancies are a group of heterogeneous blood diseases with a high mortality rate, mostly due to acute respiratory failure (ARF). Acute respiratory distress syndrome (ARDS) is one form of ARF which represents a challenging clinical condition. The paper aims to review current knowledge regarding the variable pathogenic mechanisms, as well as therapeutic options for ARDS in acute hematologic malignancy patients. Data collection: We provide an overview of ARDS in patients with acute hematologic malignancy, from an etiologic perspective. We searched databases such as PubMed or Google Scholar, including articles published until June 2022, using the following keywords: ARDS in hematologic malignancy, pneumonia in hematologic malignancy, drug-induced ARDS, leukostasis, pulmonary leukemic infiltration, pulmonary lysis syndrome, engraftment syndrome, diffuse alveolar hemorrhage, TRALI in hematologic malignancy, hematopoietic stem cell transplant ARDS, radiation pneumonitis. We included relevant research articles, case reports, and reviews published in the last 18 years. Results: The main causes of ARDS in acute hematologic malignancy are: pneumonia-associated ARDS, leukostasis, leukemic infiltration of the lung, pulmonary lysis syndrome, drug-induced ARDS, radiotherapy-induced ARDS, diffuse alveolar hemorrhage, peri-engraftment respiratory distress syndrome, hematopoietic stem cell transplantation-related ARDS, transfusion-related acute lung injury. Conclusions: The short-term prognosis of ARDS in acute hematologic malignancy relies on prompt diagnosis and treatment. Due to its etiological heterogeneity, precision-based strategies should be used to improve overall survival. Future studies should focus on identifying the relevance of such etiologic-based diagnostic strategies in ARDS secondary to acute hematologic malignancy.

Keywords: acute hematologic malignancy; acute respiratory distress syndrome; diffuse alveolar hemorrhage; engraftment syndrome; leukostasis; pneumonia; radiation recall pneumonitis; transfusion-related acute lung injury.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The progression of histopathological findings in acute respiratory distress syndrome (ARDS).
Figure 2
Figure 2
Biochemical changes in acute respiratory distress syndrome (ARDS)-damaged lung tissue.
See this image and copyright information in PMC

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