Infections in chronic lymphocytic leukemia: risk factors, and impact on survival, and treatment.
Molica S.
Leuk Lymphoma. 1994 Apr;13(3-4):203-14
Divisione di Ematologia, Ospedale Regionale A. Pugliese, Cantanzaro, Italy.
Patients
with chronic lymphocytic leukemia (CLL) are at an increasing risk of
infectious morbidity and mortality. Infections are generally due to
bacteria and influenced by the degree of hypogammaglobulinemia;
although, in more advanced stages of disease they may also be
contributed by neutropenia due to bone marrow infiltration and/or
cytotoxic therapy. Furthermore, defect in cell-mediated immunity
appears to be a predisposing factor to infections in patients treated
with newer purine analogues. Controversies surrounding the pathogenesis
of infectious complications in CLL raise several questions on their
management. Patients with advanced disease who receive cytotoxic
therapy might qualify for antibacterial prophylaxis. Intravenous
immunoglobulin (IVIG), although of scientific interest, may be of
little relevance at the present time. The new growth factors should be
tested in well-designed prospective studies.
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