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Infectious complications in 127 patients with hairy cell leukemia
Abstract:
Information regarding infectious complications was obtained on 127 patients with hairy cell leukemia who were diagnosed between March 1974 and April 1982. Forty-seven patients (37%) had 111 documented infections (cultures positive), and 40 patients (31.5%) had 113 nondocumented infections (no culture results available, or cultures negative). The remaining 40 patients (31.5%) had no significant infections during the course of their disease. Patients without infection lived significantly longer than did patients who developed an infection (92% v 49% were alive at 4 years; P = .0012). Thirty-three of the 47 patients with documented infection have died; 29 of an infectious problem and four of a noninfectious problem. There was also a statistically significant difference in actuarial survivals between the documented-infection and nondocumented infection groups (P = .007). The two most common types of infection were bacteremia (30 episodes) and pneumonia (27 episodes). In the culture-documented group with bacteremia, E coli and P aeruginosa caused ten and eight infections, respectively, and three infections were due to S aureus. There were eight systemic infections of nonbacterial origin; in five, the organism cultured was M kansasii, and three were fungal infections. Blood counts at the time of diagnosis were not correlated with subsequent development of infection. Patients with hairy cell leukemia have a significant susceptibility to infections that can affect morbidity and mortality. Many of the infectious complications encountered are those common in patients whose immune system is compromised; however, the occurrence of disseminated atypical mycobacterial disease requires a heightened awareness.
Insights
Patients with hairy cell leukemia (HCL) are highly susceptible to infections, significantly impacting survival rates. Prompt identification and management of these infections are crucial for improving patient outcomes in HCL.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Hairy cell leukemia (HCL) is a rare B-cell chronic lymphoid leukemia.
- Patients with HCL often experience compromised immune systems, leading to a high risk of infections.
Purpose of the Study:
- To investigate the incidence, types, and impact of infectious complications in patients with hairy cell leukemia.
- To analyze the relationship between infections and survival in HCL patients.
Main Methods:
- Retrospective analysis of 127 HCL patients diagnosed between 1974 and 1982.
- Documentation of infections, including culture-positive (documented) and culture-negative (nondocumented) cases.
- Comparison of survival rates between patients with and without infections.
Main Results:
- 37% of patients had documented infections, and 31.5% had nondocumented infections.
- Patients without infections had significantly longer survival (92% at 4 years) compared to those with infections (49%).
- Bacteremia and pneumonia were the most common infections; E. coli, P. aeruginosa, and S. aureus were frequent bacterial culprits. Disseminated atypical mycobacterial disease was also noted.
Conclusions:
- Infectious complications significantly increase morbidity and mortality in hairy cell leukemia patients.
- While many infections are common in immunocompromised individuals, disseminated atypical mycobacterial disease warrants specific attention.
- Effective management of infections is critical for improving survival in HCL.