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Clostridial septicemia complicating the course of leukemia
Author(s) -
Caya James G.,
Farmer Silas G.,
Ritch Paul S.,
Wollenberg Nancy J.,
Tieu Thu M.,
Oechler Herbert W.,
Spivey Michael
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19860515)57:10<2045::aid-cncr2820571028>3.0.co;2-o
Subject(s) - medicine , leukemia , neutropenia , sepsis , empiric therapy , gastroenterology , chloramphenicol , antibiotics , surgery , chemotherapy , pathology , alternative medicine , microbiology and biotechnology , biology
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.