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Infections in patients with aplastic anemia: experience at a tertiary care cancer center
Harrys A Torres1, Gerald P Bodey, Kenneth V I Rolston
1Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Background:
Infection is a significant cause of death in patients with aplastic anemia (AA). However, few recent studies have examined infectious complications in patients with AA.
Methods:
The authors retrospectively evaluated the type of infections, associated pathogens, and outcome of infectious episodes (IEs) in patients with AA who were treated at The University of Texas M. D. Anderson Cancer Center between July 1994 and June 2000.
Results:
Fifty-two patients with a median age of 37 years (range, 3-83 years) were identified. Overall, 104 IEs were documented in 42 patients (81%). The most common microbiologically documented infections were bacteremias (38%) followed by pneumonias (16%). Most patients (55%) had bacterial infections, mainly caused by gram-positive cocci. Multidrug-resistant, gram-negative bacilli also were not uncommon in this patient population. Five of 12 patients who died during the study period died of infection. All of these patients had invasive fungal infections, mostly due to molds. All five patients had prolonged and severe neutropenia.
Conclusions:
Infections remain a major cause of death in patients with AA. Bacterial infections, especially those caused by gram-positive cocci, constitute the main cause of IE. Invasive mold infections, however, are the major cause of death in this patient population.
Insights
Infections are a major cause of death in patients with aplastic anemia (AA). While bacterial infections are most common, invasive mold infections are the leading cause of mortality in this patient group.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Infection is a significant cause of mortality in patients with aplastic anemia (AA).
- Recent studies on infectious complications in AA patients are limited.
Purpose of the Study:
- To retrospectively evaluate infectious complications in AA patients.
- To identify infection types, pathogens, and outcomes in AA.
Main Methods:
- Retrospective analysis of 52 AA patients treated between July 1994 and June 2000.
- Evaluation of infectious episodes (IEs), pathogens, and patient outcomes.
Main Results:
- 104 IEs occurred in 42 patients (81%).
- Bacteremias (38%) and pneumonias (16%) were most common.
- Bacterial infections (55%) predominated, mainly gram-positive cocci; multidrug-resistant gram-negative bacilli were also noted.
- Invasive fungal infections, primarily molds, caused death in 5 patients with neutropenia.
Conclusions:
- Infections remain a major cause of death in AA.
- Bacterial infections, particularly gram-positive cocci, are the most frequent IEs.
- Invasive mold infections are the primary cause of death in this population.
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