Bronchial artery embolization for haemoptysis in patients with lymphoma and leukaemia.

Abstract

Haemoptysis in patients with lymphoma and leukaemia can present a therapeutic challenge, given that it is often associated with underlying impairments of haemostasis and immunosuppression. Bronchial artery embolization (BAE) is a mainstay in the treatment of haemoptysis, typically in those requiring emergent management. In this case series, the role of BAE in patients with lymphoma and leukaemia was evaluated. A total of 5 patients were identified between August 2010 and August 2022. Three patients were diagnosed with lymphoma (classical Hodgkin's lymphoma, diffuse large B-cell lymphoma and extra-nodal marginal zone lymphoma) and 2 patients were diagnosed with leukaemia (1 patient with acute myeloid leukaemia and the other with chronic lymphocytic leukaemia). All patients were thrombocytopenic [77.6 ± 28.5 × 10⁹/L (mean ± SD)], at presentation. Three patients had concurrent lung infection at the time of their presentation. Technical success was achieved in 4/5 patients (80%). Clinical success was obtained in 4/5 patients (80%). Recurrence following embolization was seen in 2 patients. Three patients died within 30 days following embolization (from deteriorating respiratory function). Bronchial artery embolization for haemoptysis in patients with lymphoma and leukaemia is safe and feasible. Concurrent lung infection is potentially of significance with regard to initial presentation and overall outcomes following embolization. In select patients, BAE may provide a therapeutic option, though further investigation is required.