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Early Versus Late Bronchoscopy in Bone Marrow Transplantation (BMT) Patients

Not Applicable
Completed
Conditions
Bone Marrow Transplantation
Interventions
Procedure: Variation in the time for performing bronchoscopy
Registration Number
NCT00846352
Lead Sponsor
Wake Forest University Health Sciences
Brief Summary

This study will evaluate the outcomes of bronchoscopy in Bome Marrow Transplant (BMT) patients who develop lung infiltrates suspicious for infections of the lungs. It will consist of two groups, one group will receive bronchoscopy within thirty six hours of enrollment, while the other group will receive bronchoscopy five days after enrollment. The purpose of this study is to determine the ideal time for bronchoscopy in this group of patients.

Detailed Description

At this time there exist no studies that help Pulmonologists and Oncologists decide on the best time to perform diagnostic bronchoscopies in Bone Marrow Transplant patients with suspected pulmonary infections. Practice patterns vary from institution to institution and also vary widely within an institution based on the practice preferences of the attending physicians. This study is a prospective randomized trial comparing early ( within 24-36 hours of enrollment) to late ( day 5-6 after enrollment) bronchoscopy in Bone Marrow Transplant patients who develop pulmonary infiltrates or clinical evidence of respiratory infection. If patients in the late arm require earlier bronchoscopy or do not require bronchoscopy on day 5-6 then the care will be dictated by the attending physician. Only bronchoscopies that are clinically indicated will be performed.

The aim is to determine the optimal timing for performing bronchoscopy in this group of patients. The primary outcomes will be change of therapy as determined by addition or removal of antibiotics, antifungals, antivirals or steroids etc. as well as the oncologist's opinion on the impact the bronchoscopic results had on care of the patient. Patients will be followed throughout their hospitalization as well as receive a phone call 3 months after hospital discharge. Written consent will be obtained from the patients or health care power of attorney in relevant cases.

It is our hope that the results of this study will help better define the role of bronchoscopy in the management of Bone Marrow Transplant patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
22
Inclusion Criteria
  • All patients who have had allogenic or autologous HSCT who are admitted to the BMT, and felt to need bronchoscopy by their physician.
Exclusion Criteria
  • Active hemoptysis, allergies to topical and IV anesthetics with no appropriate substitutes available. Being on non-invasive positive pressure ventilation that would not allow for safe bronchoscopy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Late bronchVariation in the time for performing bronchoscopyThis group will receive bronchoscopy within 5 days of enrollment.
Early BronchVariation in the time for performing bronchoscopyThis group will receive bronchoscopy within 36 hours of enrollment into the study.
Primary Outcome Measures
NameTimeMethod
Change in therapy due to results obtained from bronchoscopy.When results of bronchoscopy are available
Secondary Outcome Measures
NameTimeMethod
Duration of antibiotic therapyVariable
In-Hospital and three month mortalityThree months from time of enrollment

Trial Locations

Locations (3)

Wake Forest University Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

The Ohio State University Medical Center

🇺🇸

Columbus, Ohio, United States

The University of Mississippi Medical Center

🇺🇸

Jackson, Mississippi, United States

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