Korean J Hematol 1999; 34(1):

Published online March 31, 1999

© The Korean Society of Hematology

성인 급성 골수성 백혈병에서의 감염 양상

김성목, 최재혁, 이상엽, 김병덕, 이경희, 현명수

영남대학교 의과대학 내과학교실

Anatsis of the Infections in Patients with Adults Acute Myelogenous Leukemia

Sung Mok Kim, Jae Hyuk Choi, Sang Yeop Lee, Byeong Duk Kim, Kyung Hee Lee, Myung Soo Hyun

Department of Internal Medicine, Yeoung Nam University, College of Medicine, TaeGu, Korea

Abstract

Background: Significant improvements in the treatment of acute myelogenous leukemia(AML) has been contributed by the development of remission induction and consolidation chemotherapy. But the infection is one of the most important and fatal complications in patients with AML. Therefore the effective treatment and preventive strategies of these infections are essential in order that more patients may achieve a complete remission and long-term disease free-survival. The purpose of this study was
to determine the recent incidence of infections and to evaluate response for the empiric antibiotic treatment during chemotherapy.
Methods: Ths records of 102 patients from a consecutive series of 206 admission episodes between April 1985 to December 1997 ware reviewed retrospectively. When fever was developed, samples for microbiologic cultures and radiologic studies were dons. Fine needle aspiration and/or biopsy from suspected lesions were done, if the studies mentioned above ars unrevealing.
Results: Febrile episodes were developed in 123 of 206 admission session. The microbiologically defined infection(MDI) and clinically defined infection(CDI) were developed in 51.2% and 37.4% of episodes, respectively. Fever was developed in 80.7%, 30.2%, and 77.8% in cases receiving remission induction chemotherapy, standard dose-consolidation therapy, and intensified consolidation therapy, respectively. The most frequent sites of infections were lung(27.8%) and blood(27.8%). Staphylococcus
epidermidis was the most common causative organism of bacteremia. The initial antimicrobial therapy was not modified in 8 of 123 febrile episodes. The rate of overall
response to antimicrobial therapy was 65%. The rate of overall response to antimicrobial therapy during remission induction chemotherapy, standard dose-consolidation therapy,
and intensified consolidation therapy was 70.4%, 89.4%, 71.4%, respectivsly.
Conclusion: Infection has been a major cause of morbidity and mortality in acute myelogenous leukemia. Thus, intensive treatment needs for infection. Mors effective
approaches should be evaluatsd by using more effective prophylactic and treatment modalities including new antimicrobials and by considering the changing spectrum of
mivrobials.

Keywords Acute myelogenous leukemia, Infection, Antimicrobials

Article

Korean J Hematol 1999; 34(1): 99-106

Published online March 31, 1999

Copyright © The Korean Society of Hematology.

성인 급성 골수성 백혈병에서의 감염 양상

김성목, 최재혁, 이상엽, 김병덕, 이경희, 현명수

영남대학교 의과대학 내과학교실

Anatsis of the Infections in Patients with Adults Acute Myelogenous Leukemia

Sung Mok Kim, Jae Hyuk Choi, Sang Yeop Lee, Byeong Duk Kim, Kyung Hee Lee, Myung Soo Hyun

Department of Internal Medicine, Yeoung Nam University, College of Medicine, TaeGu, Korea

Abstract

Background: Significant improvements in the treatment of acute myelogenous leukemia(AML) has been contributed by the development of remission induction and consolidation chemotherapy. But the infection is one of the most important and fatal complications in patients with AML. Therefore the effective treatment and preventive strategies of these infections are essential in order that more patients may achieve a complete remission and long-term disease free-survival. The purpose of this study was
to determine the recent incidence of infections and to evaluate response for the empiric antibiotic treatment during chemotherapy.
Methods: Ths records of 102 patients from a consecutive series of 206 admission episodes between April 1985 to December 1997 ware reviewed retrospectively. When fever was developed, samples for microbiologic cultures and radiologic studies were dons. Fine needle aspiration and/or biopsy from suspected lesions were done, if the studies mentioned above ars unrevealing.
Results: Febrile episodes were developed in 123 of 206 admission session. The microbiologically defined infection(MDI) and clinically defined infection(CDI) were developed in 51.2% and 37.4% of episodes, respectively. Fever was developed in 80.7%, 30.2%, and 77.8% in cases receiving remission induction chemotherapy, standard dose-consolidation therapy, and intensified consolidation therapy, respectively. The most frequent sites of infections were lung(27.8%) and blood(27.8%). Staphylococcus
epidermidis was the most common causative organism of bacteremia. The initial antimicrobial therapy was not modified in 8 of 123 febrile episodes. The rate of overall
response to antimicrobial therapy was 65%. The rate of overall response to antimicrobial therapy during remission induction chemotherapy, standard dose-consolidation therapy,
and intensified consolidation therapy was 70.4%, 89.4%, 71.4%, respectivsly.
Conclusion: Infection has been a major cause of morbidity and mortality in acute myelogenous leukemia. Thus, intensive treatment needs for infection. Mors effective
approaches should be evaluatsd by using more effective prophylactic and treatment modalities including new antimicrobials and by considering the changing spectrum of
mivrobials.

Keywords: Acute myelogenous leukemia, Infection, Antimicrobials

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