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Septicemia in acute leukemia

T C Cesario, L M Slater, S A Armentrout

    Medical and Pediatric Oncology
    |January 1, 1978
    PubMed
    Summary
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    For acute leukemia patients, higher granulocyte counts and gram-positive bacteremia improve survival during septic episodes. Persistent positive blood cultures indicate a poor prognosis, with gram-positive infections linked to less prior antibiotic use.

    Area of Science:

    • Hematology
    • Infectious Diseases
    • Oncology

    Background:

    • Septicemic episodes pose a significant threat to individuals with acute leukemia.
    • Understanding prognostic factors is crucial for managing these high-risk patients.

    Purpose of the Study:

    • To identify factors influencing survival in acute leukemia patients experiencing septicemic episodes.
    • To analyze the relationship between bacteremia type, prior antibiotic exposure, and patient outcomes.

    Main Methods:

    • Survey of septicemic episodes in patients with acute leukemia.
    • Analysis of granulocyte counts, blood culture results (positivity duration), and bacteremia type (gram-positive vs. gram-negative).
    • Comparison of prior antibiotic exposure between patients with gram-positive and gram-negative bacteremia.

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    Main Results:

    • Granulocyte counts over 1,000/mm³ and gram-positive bacteremia were favorable prognostic factors.
    • Blood cultures persistently positive for over 48 hours indicated a poor prognosis.
    • Patients with gram-positive bacteremia had received less antibiotics pre-septicemia compared to those with gram-negative bacteremia.

    Conclusions:

    • Granulocyte count and bacteremia type are key determinants of survival in acute leukemia patients with sepsis.
    • Prolonged positive blood cultures are associated with adverse outcomes.
    • Reduced prior antibiotic use may be a characteristic of gram-positive bacteremia in this population, warranting further investigation.