Risk of Infections in Adult Patients with Haematological Malignancies

Abstract

Abstract:Patients with haematological malignancies are at increased risk of infections not only because of the malignancy itself but also because of neutropenia induced by intensive chemotherapeutic treatment, and the cytotoxic effect on the cells that line the alimentary tract. In haematological malignancy patients with a compromised inflammatory response, the classic signs and symptoms of infection may be masked. The results of blood cultures therefore play an important diagnostic role. Bacteraemia is a relatively common serious complication occurring in around 15% of patients with haematological malignancies within the first years after diagnosis but the risk varies between different types of haematological malignancies. Other risk factors for bacteraemia are presence of mucositis, neutropenia, and use of central venous catheters. Invasive fungal diseases are also serious infectious complications in this population. Viral infections are particularty often in patients that have received a bone marrow transplant. Future work in this field could focus on potential modifiable risk factors and on how time since haematological diagnosis may influence risk of infection.

Frequency of isolation and drug susceptibility of bacterial strains isolated from child oncohematological patients 2011–2014: A single center study

“…18 Similar data were reported by Lv et al from China showing 73-100% of MRCNS strains. 19 In general, literature data most often show the prevalence of Gram-positive over Gram-negative bacteria among blood isolates, 17,[20][21][22][23] which is in line with the results of our own research conducted from 2011 to 2014 (63-70% vs 30-40%). The previous study from 2001-2002 from the same clinic showed a greater number of Gram-negative than Gram-positive bacteria (56% vs 44%) isolated from blood.…”

How can we help haematological cancer survivors cope with the changes they experience as a result of their cancer?

“…These findings are similar to other studies, which have found that individuals with various cancer types prefer receiving information that is tailored to their specific characteristics [36,37]. The provision of tailored information is however particularly important for individuals with haematological cancers, as each individual's risk of infection is highly variable and influenced by multiple factors, including type of cancer and treatments received [14]. Providing survivors with generic information is therefore unlikely to help survivors make informed decisions about the changes they should personally make, and instead may result in confusion.…”

“…In addition, many of the treatments used with haematological cancers, including bone marrow transplant, chemotherapy and monoclonal antibodies, lead to immunodeficiency [12,11]. Consequently, many haematological cancer survivors are at increased risk of developing infections [13][14][15], which often carry extensive morbidities and in many cases lead to death [16,17].…”

Bloodstream infections in patients with hematological malignancies: which is more fatal – cancer or resistant pathogens?

“…In a case-control study by Pagano et al, risk factors for bacteremia in patients with hematological malignancies were found to be use of a central venous catheter and neutropenia for more than 6 days 4. Candidemia is still a serious disease in hematology patients, although the incidence of candidemia has reduced with the introduction of azole drugs in the 1990s 5. The candidemias generally develop endogenously through invasion of the gastrointestinal tract or as a catheter-related infection 6,7.…”