Screening sinus CT scans in pediatric bone marrow transplant patients

Kathleen R. Billings, Lisa H. Lowe, Victor M. Aquino, Michael J. Biavati

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: To determine how sinus disease noted on pre-bone marrow transplant (BMT) screening sinus computed tomography (CT) scans relates to subsequent development of clinical and/or radiographic sinusitis and correlates with overall prognosis. Methods: A retrospective review of medical records, CT scans, and BMT database statistics was performed on all pediatric BMT recipients from January 1992 through December 1997. Fifty-four pre-BMT CT scans were performed on 51 children, aged from 2 months to 17 years. Sinus disease was staged according to criteria established by Lund and Kennedy [V.J. Lund, D.W. Kennedy, Ann. Otol. Rhinol. Laryngol. S167 (1995) 17-21.]. Results: The average age of BMT recipients was 6.8 years. Most common oncologic diagnoses included acute myelogenous leukemia (37%), acute lymphoblastic leukemia (17%), and stage IV neuroblastoma (13%). Screening sinus CT scans were routinely performed 1-3 months prior to BMT. On pre-BMT CT scans 48% of the patients had no evidence of sinus disease, 25.9% mild disease, 9.3% moderate disease, and 16.7% severe disease. Two-thirds (66.7%) of patients with severe sinus disease on pre-BMT CT scans experienced clinical sinusitis post-BMT. In contrast, sinus symptoms were much less common (21.4%) in those with mild disease on CT scan. Overall, 39.3% of patients with sinus abnormalities on pre-BMT CT scans had clinical sinusitis during their post-BMT course, compared to 23.1% of those with normal CT scans pre-BMT. In addition, those patients demonstrating sinus disease on their pre-BMT CT scan were more likely to have radiographic sinusitis post-BMT (25.0%) than those with no disease (7.7%). Seventy-eight percent of those with severe sinusitis had died by 2-year follow up, compared to 69.2% of patients with normal CT scans pre-BMT. Conclusions: Severity of radiographic sinus disease on pre-BMT CT scans was noted to correlate with clinical and radiographic sinusitis later in the post-BMT course, and was associated with a trend toward decreased survival. Pre-BMT CT scans may be useful in determining which children need early and more aggressive intervention for clinical sinusitis post-BMT. (C) 2000 Elsevier Science Ireland Ltd.

Original languageEnglish (US)
Pages (from-to)253-260
Number of pages8
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume52
Issue number3
DOIs
StatePublished - May 30 2000

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Bone Marrow
Tomography
Pediatrics
Transplants
Sinusitis
Neuroblastoma
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Acute Myeloid Leukemia
Medical Records

Keywords

  • Bone marrow transplantation
  • Sinusitis

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine
  • Surgery

Cite this

Screening sinus CT scans in pediatric bone marrow transplant patients. / Billings, Kathleen R.; Lowe, Lisa H.; Aquino, Victor M.; Biavati, Michael J.

In: International Journal of Pediatric Otorhinolaryngology, Vol. 52, No. 3, 30.05.2000, p. 253-260.

Research output: Contribution to journalArticle

Billings, Kathleen R. ; Lowe, Lisa H. ; Aquino, Victor M. ; Biavati, Michael J. / Screening sinus CT scans in pediatric bone marrow transplant patients. In: International Journal of Pediatric Otorhinolaryngology. 2000 ; Vol. 52, No. 3. pp. 253-260.
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abstract = "Objective: To determine how sinus disease noted on pre-bone marrow transplant (BMT) screening sinus computed tomography (CT) scans relates to subsequent development of clinical and/or radiographic sinusitis and correlates with overall prognosis. Methods: A retrospective review of medical records, CT scans, and BMT database statistics was performed on all pediatric BMT recipients from January 1992 through December 1997. Fifty-four pre-BMT CT scans were performed on 51 children, aged from 2 months to 17 years. Sinus disease was staged according to criteria established by Lund and Kennedy [V.J. Lund, D.W. Kennedy, Ann. Otol. Rhinol. Laryngol. S167 (1995) 17-21.]. Results: The average age of BMT recipients was 6.8 years. Most common oncologic diagnoses included acute myelogenous leukemia (37{\%}), acute lymphoblastic leukemia (17{\%}), and stage IV neuroblastoma (13{\%}). Screening sinus CT scans were routinely performed 1-3 months prior to BMT. On pre-BMT CT scans 48{\%} of the patients had no evidence of sinus disease, 25.9{\%} mild disease, 9.3{\%} moderate disease, and 16.7{\%} severe disease. Two-thirds (66.7{\%}) of patients with severe sinus disease on pre-BMT CT scans experienced clinical sinusitis post-BMT. In contrast, sinus symptoms were much less common (21.4{\%}) in those with mild disease on CT scan. Overall, 39.3{\%} of patients with sinus abnormalities on pre-BMT CT scans had clinical sinusitis during their post-BMT course, compared to 23.1{\%} of those with normal CT scans pre-BMT. In addition, those patients demonstrating sinus disease on their pre-BMT CT scan were more likely to have radiographic sinusitis post-BMT (25.0{\%}) than those with no disease (7.7{\%}). Seventy-eight percent of those with severe sinusitis had died by 2-year follow up, compared to 69.2{\%} of patients with normal CT scans pre-BMT. Conclusions: Severity of radiographic sinus disease on pre-BMT CT scans was noted to correlate with clinical and radiographic sinusitis later in the post-BMT course, and was associated with a trend toward decreased survival. Pre-BMT CT scans may be useful in determining which children need early and more aggressive intervention for clinical sinusitis post-BMT. (C) 2000 Elsevier Science Ireland Ltd.",
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N2 - Objective: To determine how sinus disease noted on pre-bone marrow transplant (BMT) screening sinus computed tomography (CT) scans relates to subsequent development of clinical and/or radiographic sinusitis and correlates with overall prognosis. Methods: A retrospective review of medical records, CT scans, and BMT database statistics was performed on all pediatric BMT recipients from January 1992 through December 1997. Fifty-four pre-BMT CT scans were performed on 51 children, aged from 2 months to 17 years. Sinus disease was staged according to criteria established by Lund and Kennedy [V.J. Lund, D.W. Kennedy, Ann. Otol. Rhinol. Laryngol. S167 (1995) 17-21.]. Results: The average age of BMT recipients was 6.8 years. Most common oncologic diagnoses included acute myelogenous leukemia (37%), acute lymphoblastic leukemia (17%), and stage IV neuroblastoma (13%). Screening sinus CT scans were routinely performed 1-3 months prior to BMT. On pre-BMT CT scans 48% of the patients had no evidence of sinus disease, 25.9% mild disease, 9.3% moderate disease, and 16.7% severe disease. Two-thirds (66.7%) of patients with severe sinus disease on pre-BMT CT scans experienced clinical sinusitis post-BMT. In contrast, sinus symptoms were much less common (21.4%) in those with mild disease on CT scan. Overall, 39.3% of patients with sinus abnormalities on pre-BMT CT scans had clinical sinusitis during their post-BMT course, compared to 23.1% of those with normal CT scans pre-BMT. In addition, those patients demonstrating sinus disease on their pre-BMT CT scan were more likely to have radiographic sinusitis post-BMT (25.0%) than those with no disease (7.7%). Seventy-eight percent of those with severe sinusitis had died by 2-year follow up, compared to 69.2% of patients with normal CT scans pre-BMT. Conclusions: Severity of radiographic sinus disease on pre-BMT CT scans was noted to correlate with clinical and radiographic sinusitis later in the post-BMT course, and was associated with a trend toward decreased survival. Pre-BMT CT scans may be useful in determining which children need early and more aggressive intervention for clinical sinusitis post-BMT. (C) 2000 Elsevier Science Ireland Ltd.

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