The evaluation of bacterial infection in patients with acuteLymphoblastic leukemia in induction phase of treatment with HyperCVAD regimen

Background and Aim : Acute Lymphoblastic Leukemia is one of the lethal disease in adultpopulation. The most common cause of death especially in induction phase of treatment isinfection, and majority of cases experienced neutropenia and fever. The most importantcomplication in this situation is bacterial infection. The aim of this study is the evaluation ofbacterial infection in induction phase of newly cases with Acute lymphoblastic Leukemia.Methods : In this prospective single center study, ۳۹ cases of acute lymphoblastic leukemiaentered.The primary disease confirmed with blood film, bone marrow exam, flowcytometery. ۳۰cases was male. All cases had daily physical exam, check of vital sign and inserted central veinpressure line, complte blood cell. If the patients experienced fever, culture of blood, urine andother suspicious sites were done. Emperical antibiotic therapy started after full evaluation as above.Results : In our study ۳۵ cases experienced fever and neutropenia. For all cases, chest x ray,complete blood count, blood and urine culture were done. After these procedures , we startedempirical therapy as ward policy. Of ۳۵ cases with fever and neutropenia, only ۲ cases had bloodculture positive. These ۲ cases were positive for gram negative pathogen. We didn’t have any caseswith overt invasive fungal infection except mild local oropharyngeal candidiasis. In our studymortality due to infection in induction phase of treatment was zero percent.Conclusion : Fever and neutropenia are the very common manifestation in acute lymphoblasticleukemia, but culture positive has very low incidence. The causes of this low prevalence may bedue to prior prophylactic therapy and lack of specific and sensitive culture instrument.

کلیدواژه ها:

Acute lymphoblastic leukemia ، Neutropenia ، Fever