Immunological competence of patients in remission from acute leukaemia: apparently normal T cell function but defective pokeweed mitogen‐driven immunoglobulin synthesis

Ashman, Leonie K.; Drew, Paul A.; Toogood, Ian; Juttner, Christopher A.

doi:10.1038/icb.1987.22

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…The risk of severe infections is not uniform among these patients and is related to the degree and duration of neutropenia (7) with the risk of developing more serious infections increasing with prolonged neutropenia (10) (11), the use of salvage chemotherapy, and previous antibiotic exposures (12). In acute leukemia patients, the risk of infection does not fully abate after achieving remission as patients can have prolonged defects in humoral immunity (13). This risk increases further with relapse of disease (14).…”

Section: Disease Specific Factors Associated With Host Immune Responsementioning

confidence: 99%

Infections in Leukemia

Chandran¹,

Hakki²,

Spurgeon³

2012

Sepsis - An Ongoing and Significant Challenge

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Section: Disease Specific Factors Associated With Host Immune Responsementioning

confidence: 99%

Infections in Leukemia

Chandran¹,

Hakki²,

Spurgeon³

2012

Sepsis - An Ongoing and Significant Challenge

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“…IgG and IgM being the most affected immunoglobulins, and humoral defect immunity can also be present in patients achieving complete remission. 6 Finally, the incidence and severity of infections and sepsis are very different in AML patients compared to ALL patients. Induction treatment induces in AML more prolonged neutropenia, which favors infectious complications with early deaths, significantly more frequent in AML patients compared to ALL patients.…”

mentioning

confidence: 99%

Febrile Neutropenia in Acute Leukemia. Epidemiology, Etiology, Pathophysiology and Treatment

Hansen¹,

Wendelbo²,

Bruserud³

et al. 2019

Mediterr J Hematol Infect Dis

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Acute leukemias are a group of aggressive malignant diseases associated with a high degree of morbidity and mortality. An important cause of both the latter is infectious complications. Patients with acute leukemia are highly susceptible to infectious diseases due to factors related to the disease itself, factors attributed to treatment, and specific individual risk factors in each patient. Patients with chemotherapy-induced neutropenia are at particularly high risk, and microbiological agents include viral, bacterial and fungal agents. The etiology is often unknown in infectious complications, although adequate patient evaluation and sampling have diagnostic, prognostic and treatment-related consequences. Bacterial infections include a wide range of potential microbes, both Gram-negative and Gram-positive species, while fungal infections include both mold and yeast. A recurring problem is increasing resistance to antimicrobial agents, and in particular, this applies to extended-spectrum beta-lactamase resistance (ESBL), Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and even carbapenemase-producing Enterobacteriaceae (CPE). International guidelines for the treatment of sepsis in leukemia patients include the use of broad-spectrum Pseudomonas-acting antibiotics. However, one should implant the knowledge of local microbiological epidemiology and resistance conditions in treatment decisions. Here, we discuss infectious diseases in acute leukemia with a major focus on febrile neutropenia and sepsis, and we problematize the diagnostic, prognostic, and therapeutic aspects of infectious complications in this patient group. Meticulously and thorough clinical and radiological examination combined with adequate microbiology samples are cornerstones of the examination. Diagnostic and prognostic evaluation includes patient review according to the multinational association for supportive care in cancer (MASCC) and sequential organ failure assessment (SOFA) scoring system. Antimicrobial treatments for important etiological agents are presented. The main challenge for reducing the spread of resistant microbes is to avoid unnecessary antibiotic treatment, but without giving to narrow treatment to the febrile neutropenic patient that reduce the prognosis.

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Immunological competence of patients in remission from acute leukaemia: apparently normal T cell function but defective pokeweed mitogen‐driven immunoglobulin synthesis

Cited by 2 publications

References 19 publications

Infections in Leukemia

Infections in Leukemia

Febrile Neutropenia in Acute Leukemia. Epidemiology, Etiology, Pathophysiology and Treatment

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