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[Infectious complications and infection prevention in patients with acute leukemia]
Abstract:
Febrile episodes in 147 patients undergoing first remission induction therapy for acute leukemia were analyzed. Febrile episodes occurred 254 times in 136 patients. The cause of fever could not be identified in 54.3% of all episodes. Antibiotic therapy was effective in 81.1% of these episodes with no cause determined. Postmortem examinations proved infections in 65.2% of patients who had fever of unknown origin before death. Sepsis and pneumonia together accounted for 53.4% of documented infections. Sepsis and pneumonia occurred most often when the patients had neutropenia (less than 500/mm3). Increase in neutrophil count and achievement of hematologic remission produced good prognosis of the infections, and the reverse was also true in some patients. Fifty percent of fetal patients died of infection. The incidence of infections, especially pneumonia and infections caused by fungi and Proteus species indicating such infections were exogenous, reduced markedly in laminar air flow rooms.
Insights
Fever in acute leukemia patients often has unknown causes but responds to antibiotics. Infections, particularly sepsis and pneumonia, are common in neutropenia and impact prognosis.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Context:
- Febrile episodes are common during acute leukemia induction therapy.
- Understanding infection causes is critical for patient outcomes.
Purpose:
- To analyze febrile episodes in acute leukemia patients undergoing induction therapy.
- To identify causes of fever, treatment efficacy, and prognostic factors.
Summary:
- Fever of unknown origin occurred in 54.3% of episodes, with antibiotics effective in 81.1%.
- Sepsis and pneumonia were the most frequent infections, often linked to neutropenia.
- Improved neutrophil counts and remission correlated with better infection prognosis.
- Infections caused 50% of deaths in febrile patients.
- Laminar air flow rooms significantly reduced infection incidence.
Impact:
- Highlights the importance of infection control and management in acute leukemia.
- Suggests environmental controls like laminar air flow can reduce infection risk.
- Emphasizes the link between neutropenia, infection, and mortality in leukemia patients.