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Influenza among hospitalized adults with leukemia
H M Yousuf1, J Englund, R Couch
1Section of Infectious Diseases, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Abstract:
Influenza is one of the most important respiratory diseases of mankind, yet scant data exist concerning the frequency and clinical course of influenza in severely immunocompromised adults. From October 1993 to September 1994, we cultured the respiratory secretions of all adults with leukemia who were hospitalized with an acute respiratory illness at The University of Texas M.D. Anderson Cancer Center in Houston. During a 9-week period from 29 November 1993 to 29 January 1994, influenza virus type A (H3N2) was isolated from 15 (33%) of these 45 hospitalized adults. Twelve (80%) of the cases of influenza were associated with pneumonia, and four patients (33%) with pneumonia died. Patients who died tended to have received chemotherapy more recently and to be more myelosuppressed. Autopsy examination in two cases revealed histopathologic changes consistent with viral pneumonia. During community outbreaks, influenza is a frequent cause of serious respiratory disease in hospitalized adults with leukemia. Effective prophylactic and therapeutic regimens need to be defined for immunocompromised patients.
Insights
Influenza A (H3N2) frequently caused severe pneumonia and death in hospitalized leukemia patients. Further research is needed to define effective influenza prevention and treatment for immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Hematology
- Oncology
Background:
- Influenza poses a significant threat as a respiratory illness.
- Limited data exist on influenza's frequency and clinical outcomes in immunocompromised adults.
Purpose of the Study:
- To investigate the incidence and clinical course of influenza in hospitalized adult leukemia patients.
- To assess the severity and mortality associated with influenza in this vulnerable population.
Main Methods:
- Respiratory secretions were cultured from hospitalized leukemia patients with acute respiratory illness.
- Influenza virus type A (H3N2) was identified during a specific 9-week period.
- Clinical data and autopsy findings were analyzed.
Main Results:
- Influenza A (H3N2) was isolated from 33% of patients.
- Pneumonia occurred in 80% of influenza cases, with a 33% mortality rate among those with pneumonia.
- Recent chemotherapy and myelosuppression were associated with fatal outcomes.
Conclusions:
- Influenza is a common cause of severe respiratory illness in hospitalized leukemia patients during community outbreaks.
- There is a critical need for defined prophylactic and therapeutic strategies for immunocompromised patients.
- Viral pneumonia was confirmed via autopsy in fatal cases.