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Acute leukemia and infections: perspectives from a general hospital
Abstract:
The incidence and etiology of infections in 210 acute leukemics at the University of Mississippi Medical Center between 1962 and 1978 were reviewed. Infections episodes occurred 269 times in 148 patients. In 193 infections, potential pathogens were cultured. Infection was a contributing cause of death in 89 patients. E. Coli, S. aureus, K. pneumoniae, and P. aeruginosa accounted for 58% of the isolates. No unusual patterns of antimicrobial resistance were observed. The outcome of the infections was related to the absence or resolution of neutropenia. Among 48 patients febrile on first admission, four cases of gram-negative pneumonia, two cases of fungal pneumonia, and two cases of pseudomonas cellulitis were diagnosed. We conclude that the etiology of infections was similar to that of cancer centers; multidrug-resistant gram-negative organisms were not prevalent; absence or resolution of neutropenia indicates a good prognosis for outcome of infection; and untreated acute leukemics may acquire opportunistic infections.
Insights
Infections in acute leukemia patients were common, with gram-negative bacteria and Staphylococcus aureus being frequent culprits. Resolution of neutropenia significantly improved patient outcomes, suggesting a key factor in managing these severe infections.
Area of Science:
- Infectious Diseases
- Hematology
- Oncology
Background:
- Infections pose a significant threat to patients with acute leukemia.
- Understanding the common pathogens and risk factors is crucial for improving patient survival.
Purpose of the Study:
- To review the incidence, etiology, and outcomes of infections in acute leukemia patients.
- To identify common pathogens and factors influencing infection-related mortality.
Main Methods:
- Retrospective review of 210 acute leukemia patients treated between 1962 and 1978.
- Analysis of 269 infection episodes, including pathogen identification and outcome assessment.
Main Results:
- Infections occurred in 148 patients, with potential pathogens cultured in 193 instances.
- Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Pseudomonas aeruginosa were the most common isolates.
- Infection contributed to death in 89 patients; resolution of neutropenia correlated with better outcomes.
Conclusions:
- The spectrum of infections in acute leukemia patients was similar to other cancer centers.
- Multidrug-resistant gram-negative organisms were not prevalent during this period.
- Neutropenia resolution is a favorable prognostic indicator for infection outcomes in acute leukemia.