Acute myeloid leukemia and the infectious diseases consultant
Victor Mulanovich1, Dimitrios P Kontoyiannis1
1a Department of Infectious Diseases, Infection Control and Employee Health , University of Texas, MD Anderson Cancer Center , Houston , TX , USA.
Abstract:
Infectious complications following treatment of acute myeloid leukemia (AML) are important causes of morbidity and mortality. The spectrum and complexity of these infections is reflected by the severe net state of immunosuppression of AML patients, that is dynamic and continuously changing, the polypharmacy, including the widespread use of anti-infectives and the complex epidemiology of severe and frequently resistant pathogens afflicting these patients. Infectious diseases (ID) consultants having a critical mass of expertise and intimate knowledge of the intricacies of leukemia care, add considerable value in improving outcomes of patients with AML who develop infections. Furthermore, pharmaco-economic considerations such as length of stay, choice of cost-effective anti-infective program, infection control and antibiotic stewardship strategies create a delicate interplay of the ID consultant and the ecosystem of care of AML patients. This is an increasingly recognized area of cross collaboration and a productive direction for future collaborative practice models and research.
Insights
Infectious diseases (ID) consultants improve outcomes for acute myeloid leukemia (AML) patients facing complex infections due to immunosuppression and resistant pathogens. Their expertise optimizes treatment and cost-effectiveness in AML care.
Area of Science:
- Hematology-Oncology
- Infectious Diseases
Background:
- Acute myeloid leukemia (AML) patients experience significant morbidity and mortality from infectious complications.
- The immunosuppressed state in AML is dynamic, compounded by polypharmacy and resistant pathogens.
- Managing infections in AML requires specialized knowledge due to disease complexity and treatment regimens.
Purpose of the Study:
- To highlight the critical role of Infectious Diseases (ID) consultants in managing infections in AML patients.
- To emphasize the value of ID expertise in improving patient outcomes and optimizing care.
- To explore the collaborative potential between ID and hematology-oncology for future practice models.
Main Methods:
- Review of the challenges in treating infections in AML patients.
- Analysis of the impact of immunosuppression, polypharmacy, and pathogen resistance.
- Discussion of the multidisciplinary approach involving ID consultants.
Main Results:
- ID consultants bring essential expertise to the complex care of AML patients with infections.
- Collaboration with ID specialists can enhance infection control and antibiotic stewardship.
- Pharmaco-economic factors, including length of stay and cost-effective treatments, are influenced by ID input.
Conclusions:
- Infectious diseases consultants are integral to improving outcomes for acute myeloid leukemia patients.
- Cross-collaboration between ID and hematology-oncology offers a productive direction for future research and practice.
- Optimizing the management of infections in AML through specialized consultation is crucial for reducing morbidity and mortality.
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