Clostridial septicemia complicating the course of leukemia

• Published in: Cancer Vol. 57; no. 10; pp. 2045 - 2048
• Main Authors: Caya, James G., Farmer, Silas G., Ritch, Paul S., Wollenberg, Nancy J., Tieu, Thu M., Oechler, Herbert W., Spivey, Michael
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 15.05.1986; Wiley-Liss
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - therapeutic use; Biological and medical sciences; Child; Clostridium Infections - complications; Clostridium Infections - drug therapy; Clostridium Infections - mortality; Female; Hematologic and hematopoietic diseases; Humans; Leukemia - complications; Leukemia, Lymphoid - complications; Leukemia, Myeloid, Acute - complications; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Sepsis - drug therapy; Sepsis - etiology; Sepsis - mortality; Human; Clostridium; Septicemia; Acute; Leukemia; Mortality; Clostridiales; Hemopathy; Chronic; Clostridiaceae; Bacteria; Adult; Child
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19860515)57:10<2045::AID-CNCR2820571028>3.0.CO;2-O

The authors report an analysis of 47 leukemia patients (including 9 from our own medical center) whose courses were complicated by 48 episodes of clostridial septicemia. There were 36 adults and 11 children; acute myelogenous leukemia and acute lymphoblastic leukemia accounted for 61.7% and 14.9% of cases, respectively. All patients for whom remission status was known were in leukemic relapse. Fever was a presenting complaint in at least 36 patients whereas neutropenia, thrombocytopenia, and gastrointestinal lesions were noted in 100%, 90.9%, and 87.9%, respectively, of the patients for whom information on these parameters was available. Overall mortality from clostridial septicemia was 78%; none of the children and none of the patients with intravascular hemolysis survived. Overall, antibiotic therapy resulted in a 40% survival rate. However, among patients receiving beta lactam and/or chloramphenicol therapy, 57% survived their episode of clostridial septicemia. Prompt initiation of appropriate antimicrobial therapy offers the best chance of survival in leukemia patients with clostridial septicemia.