Abstract
IntroductionSinusitis is a common morbidity in general population, however little is known about its occurrence in severely immunocompromised patients undergoing allogeneic hematopoietic stem cell transplantation. ObjectiveThe aim of the study was to analyze the literature concerning sinusitis in patients undergoing allogeneic bone marrow transplantation. MethodsAn electronic database search was performed with the objective of identifying all original trials examining sinusitis in allogeneic hematopoietic stem cell transplant recipients. The search was limited to English-language publications. ResultsTwenty five studies, published between 1985 and 2015 were identified, none of them being a randomized clinical trial. They reported on 31–955 patients, discussing different issues i.e. value of pretransplant sinonasal evaluation and its impact on post-transplant morbidity and mortality, treatment, risk factors analysis. ConclusionResults from analyzed studies yielded inconsistent results. Nevertheless, some recommendations for good practice could be made. First, it seems advisable to screen all patients undergoing allogeneic hematopoietic stem cell transplantation with Computed Tomography (CT) prior to procedure. Second, patients with symptoms of sinusitis should be treated before hematopoietic stem cell transplantation (HSCT), preferably with conservative medical approach. Third, patients who have undergone hematopoietic stem cell transplantation should be monitored closely for sinusitis, especially in the early period after transplantation.
Highlights
Bone marrow transplantation is used to treat a variety of hematological disorders either neoplastic or non-neoplastic
Only incidental reports concern invasive fungal sinusitis, which is typically associated with bone destruction in the affected area
In the study of Won Graft versus Host Disease (GvHD) did not influence the occurrence of sinusitis in the entire group of transplanted patients, when asymptomatic patients with solely radiological abnormalities prior to transplantation were analyzed separately, both acute and chronic GvHD put these patients at higher risk of developing sinusitis (p = 0.005 and p = 0.042 respectively).[3]
Summary
Bone marrow transplantation is used to treat a variety of hematological disorders either neoplastic or non-neoplastic. According to Thompson et al, Ortiz et al and Bento et al it put patients at higher risk of developing sinusitis in the post-transplant period (RR = 4.3; 95% CI 1.7---11; p = 0.002),[4,15,24] whereas in the work of Shibuya it did not have any impact on morbidity.[1] In the study of Won GvHD did not influence the occurrence of sinusitis in the entire group of transplanted patients, when asymptomatic patients with solely radiological abnormalities prior to transplantation were analyzed separately, both acute and chronic GvHD put these patients at higher risk of developing sinusitis (p = 0.005 and p = 0.042 respectively).[3]
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