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32 - Infectious disease complications in leukemia

from Part IV - Complications and supportive care

Published online by Cambridge University Press:  01 July 2010

By
Jeremy A. Franklin  and
Patricia M. Flynn
Edited by
Ching-Hon Pui
Jeremy A. Franklin
Affiliation:
Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Assistant Professor Department of Pharmacy Practice, Texas Tech University Health Sciences Center, Amarillo, TX, USA
Patricia M. Flynn
Affiliation:
Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Member, Department of Infectious Diseases, Arthur Ashe Chair in Pediatric AIDS Research, St. Jude Children's Research Hospital, Professor, Department of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
Ching-Hon Pui
Affiliation:
St. Jude Children's Research Hospital, Memphis
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Summary

Introduction

Children with leukemia experience the common infections of childhood – such as upper respiratory tract infection, otitis media, and gastroenteritis – which are generally managed in the same manner as those occurring in the immunocompetent host. However, the immunocompromised status of many of these children leaves them susceptible to various opportunistic infections, which generally occur at times when the host defense mechanisms are at nadirs of efficiency. This chapter reviews the factors that contribute to infectious complications in patients with leukemia and suggests strategies for the prevention and management of these infections.

Defects in the host defense mechanisms associated with leukemia

Numerous factors contribute to the decreased efficacy of the host defense mechanisms in patients with leukemia. The malignancy itself and the therapeutic modalities necessary for a successful outcome can affect the physical barriers to infection, impair immune system functioning, disrupt cytokine mediators, and alter the normal microbiological flora. A major defense against infection is the integrity of the mucosal membranes and the integument, which act as biologic barriers against potential pathogens. Breaches in these barriers provide ready access for endogenous microbiological flora and other opportunistic pathogens. Venipuncture, catheter entry sites, bone marrow aspirates, mucosal ulcerations, and mucositis are common defects in these important barriers encountered in patients with leukemia.

A variety of deficiencies may occur in the immune system of patients with leukemia, including impaired humoral antibody responses, impaired cell-mediated immunity, quantitative and qualitative phagocytic defects, and the disruption of cytokine mediators.

Type
Chapter
Information
Childhood Leukemias , pp. 805 - 828
Publisher: Cambridge University Press
Print publication year: 2006

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  • Infectious disease complications in leukemia
    • By Jeremy A. Franklin, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Assistant Professor Department of Pharmacy Practice, Texas Tech University Health Sciences Center, Amarillo, TX, USA, Patricia M. Flynn, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Member, Department of Infectious Diseases, Arthur Ashe Chair in Pediatric AIDS Research, St. Jude Children's Research Hospital, Professor, Department of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.033
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  • Infectious disease complications in leukemia
    • By Jeremy A. Franklin, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Assistant Professor Department of Pharmacy Practice, Texas Tech University Health Sciences Center, Amarillo, TX, USA, Patricia M. Flynn, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Member, Department of Infectious Diseases, Arthur Ashe Chair in Pediatric AIDS Research, St. Jude Children's Research Hospital, Professor, Department of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.033
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Infectious disease complications in leukemia
    • By Jeremy A. Franklin, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Assistant Professor Department of Pharmacy Practice, Texas Tech University Health Sciences Center, Amarillo, TX, USA, Patricia M. Flynn, Assistant Professor, Department of Pediatrics Division of Infectious Diseases, Member, Department of Infectious Diseases, Arthur Ashe Chair in Pediatric AIDS Research, St. Jude Children's Research Hospital, Professor, Department of Pediatrics and Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
  • Edited by Ching-Hon Pui
  • Book: Childhood Leukemias
  • Online publication: 01 July 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511471001.033
Available formats
×