Clinical Approach to Infections in the Compromised Host

Chapter 40 Clinical Approach to Infections in the Compromised Host





Table 40-1 Malignant and Select Nonmalignant Hematologic Diseases and Their Associated Infection-Predisposing Host Defects










































Hematologic Condition Infection-Predisposing Host Defects
Acute myeloid leukemia Neutropenia; therapies such as dose-intensive chemotherapy and hematopoietic stem cell transplant may result in additional anatomic disruptions, cell-mediated defects, and humoral defects
Acute lymphocytic leukemia Neutropenia; therapy effects similar to acute myeloid leukemia
Hairy cell leukemia Neutropenia (also monocytopenia); abnormal humoral immunity; T-cell suppressing therapy
Chronic lymphocytic leukemia Hypogammaglobulinemia; abnormal cell-mediated immunity
Chronic myeloid leukemia No prominent host defects unless aggressive therapy, advanced stage, or postsplenectomy
Multiple myeloma Hypogammaglobulinemia; other host defects may occur with aggressive therapy or advanced stage
Hodgkin/non-Hodgkin lymphomas Abnormal cell-mediated immunity, therapy-related neutropenia, splenic dysfunction (if splenectomy or radiation)
Myelodysplastic syndromes Functional or absolute neutropenia
Aplastic anemia Neutropenia; abnormal cell-mediated immunity from immunosuppressive therapies (e.g., steroids, antithymocyte globulin, cyclosporine, hematopoietic stem cell transplantation)
Paroxysmal nocturnal hemoglobinuria Deficient Fc receptor may contribute to abnormal cell-mediated immunity
Hemolytic states (thalassemia) Gallstones may serve as a nidus for infection; splenic dysfunction or splenectomy
Sickle cell disease Can be neutropenic with aplastic crisis; bone infarcts may serve as a nidus for infection; splenic dysfunction with poor complement activation and opsonization from autosplenectomy




Jun 12, 2016 | Posted by in HEMATOLOGY | Comments Off on Clinical Approach to Infections in the Compromised Host
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