Thrombocytopenic patients with hematological malignancy who underwent fiberoptic bronchoscopy are they really under a significant hemorrhagic risk?

Abstract

Background Fiberoptic bronchoscopy (FOB) is a very important procedure in hematology clinics. Clinicians often worry about thrombocytopenia before performing FOB because hemorrhagic complications may occur during and after FOB. We have planned a retrospective study about hemorrhagic complications in thrombocytopenic patients who underwent FOB and treated for hematological malignancy. In this study, we have analyzed hemorrhagic complications, which are related to thrombocytopenia, in 114 adult patients who have hematologic malignancy and underwent FOB between January 1, 2005 and October 20, 2015. The platelet counts of all the patients were below 100 x 10(9)/L. Results The complications related to FOB were observed in 4 (3.5%) out of 114 patient. Three out of 4 the complications were related to hemorrhage. One out of these 3 patients who occured hemorrhage was in "no bleeding group" according to BTS classification. The other 1 out of these 3 patients was in "mild bleeding" group. No bleeding was observed during FOB in the third patient. Hemoptysis was observed after FOB in the third patient, it was not required replacement and hemoptysis regressed spontaneously. In this study, we categorized all the patients into three groups. The first group was comprised of 32 patients whose platelet counts were between 0 and 30 x 10(9)/L. The second group was comprised of 47 patients whose platelets counts were between 30 and 50 x 10(9)/L and lastly, the third group was comprised of 35 patients whose platelets counts were between 50 and 100 x 10(9)/L. When we compared the groups to each other, there was no significant difference between these three groups in regards to occurrence of hemorrhagic complications. We observed that there was no significant relationship between thrombocytopenia level and risk of hemorrhagic complications in thrombocytopenic patients who underwent FOB. Conclusions In conclusion, this study demonstrated that FOB is safe procedures in thrombocytopenic patients if it is performed in multidisciplinary centers by experienced pulmonologists.