How does infection affect the prognosis of pediatric acute myelocytic leukemia (AML)?

Updated: Sep 12, 2017
  • Author: Mark E Weinblatt, MD; Chief Editor: Jennifer Reikes Willert, MD  more...
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Answer

Infection is a major cause of morbidity and mortality in acute myeloid leukemia. Signs of serious infections in children with leukemia are often subtle. Fever at any time must be taken seriously, and appropriate cultures and investigations must be ordered to diagnose and treat it early.

The predisposition to infection is a consequence of granulocytopenia and immunosuppression. The risk of sepsis is greatest when the absolute granulocyte count is less than 200 cells/μL.

Sepsis and pneumonia are particularly common. Causative agents cover the entire gamut of bacterial, fungal, viral, and other pathogens.

Septic shock is most commonly secondary to gram-negative bacteria, Staphylococcus aureus, and group A Streptococcus bacteria and is often lethal.

Because of prolonged neutropenia, immunosuppression, and treatment with broad-spectrum antibiotics, common causes of death are fungal, antibiotic-resistant bacterial, and other opportunistic infections.


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