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[Infection in elderly leukemic patients]

M Kikukawa1, Y Ishida, K Kuramoto

  • 1Department of Hematology Tokyo Metropolitan Geriatric Hospital.

Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
|January 1, 1996
PubMed
Summary

Elderly leukemia patients experienced frequent febrile episodes, often linked to neutropenia. Gram-positive cocci infections increased, with no significant benefit from granulocyte colony-stimulating factor (G-CSF) for fever reduction.

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Area of Science:

  • Hematology
  • Infectious Diseases
  • Geriatrics

Background:

  • Febrile episodes are common in elderly leukemia patients.
  • Neutropenia significantly increases the risk of fever in these patients.

Purpose of the Study:

  • To review febrile episodes in elderly leukemia patients.
  • To identify causative microorganisms and infectious sites.
  • To evaluate the efficacy of granulocyte colony-stimulating factor (G-CSF).

Main Methods:

  • Retrospective review of 29 elderly leukemia patients (mean age 75) from 1988-1993.
  • Analysis of 64 febrile episodes (temperature >= 38°C for >= 6 hours).
  • Correlation of febrile episodes with neutropenia levels and identification of causative pathogens.

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Main Results:

  • Average of 2.2 febrile episodes per patient; 72% occurred with neutropenia < 100/microliter.
  • Urinary tract infections (25%), pneumonia (22%), and septicemia (22%) were most common.
  • Gram-positive cocci (66%) predominated, showing an increase, particularly Staphylococcus aureus, coagulase-negative Staphylococcus, and Enterococci.
  • G-CSF use showed no significant difference in fever amelioration compared to non-G-CSF cases.

Conclusions:

  • Elderly leukemia patients are prone to recurrent febrile episodes, strongly associated with neutropenia.
  • There is a concerning rise in Gram-positive cocci infections in this patient group.
  • Granulocyte colony-stimulating factor (G-CSF) did not demonstrate a significant benefit in reducing fever duration or severity in this study population.