Studies of neutrophil kinetics in neutropenic individuals, as well as clinical observations of variability in the occurrence of infection among patients with neutropenia, have suggested that blood neutrophil counts may not uniformly reflect the effective delivery of neutrophils to extravascular tissues where the cells perform their principal host defense functions. To evaluate this possibility ...

The etiology of bacteremia in febrile neutropenic patients in the past few decades has shifted from gram-negative to gram-positive organisms. Potential reasons include the use of indwelling catheters, local environmental conditions, and the administration of specific antibiotic agents, especially as prophylaxis. Other factors may emerge from new studies, such as the categorization of febrile ne...

Myelosuppression and neutropenic complications remain major dose-limiting toxicities of cancer chemotherapy resulting in increased morbidity, mortality, and costs ( 1 , 2 ). The major factors that are associated with the risk of mortality from febrile neutropenia (FN) include older age, cancer type and stage, documented infection, bacteremia, sepsis, venous thromboembolism, and the number of se...

Owing to increasing resistance and the limited arsenal of new antibiotics, especially against Gram-negative pathogens, carefully designed antibiotic regimens are obligatory for febrile neutropenic patients, along with effective infection control. The Expert Group of the 4(th) European Conference on Infections in Leukemia has developed guidelines for initial empirical therapy in febrile neutrope...

Systemic fungal infections are becoming increasingly common in patients with hematologic malignancies receiving antineoplastic therapy. The presence of acute myeloid or acute lymphoid leukemia, plus the use of chemotherapy to totally ablate malignant bone marrow cells, puts patients in a protracted neutropenic state. During this profound and prolonged neutropenic phase, patients receive antibio...

Glucocorticoids have potent, pleiotropic effects on the immune system that can predispose patients to developing life-threatening invasive aspergillosis (IA). While the exact prevalence and attributable mortality of IA in glucocorticoid-treated patients is difficult to estimate, Aspergillus species are significant pathogens in patients that require prolonged high-dose glucocorticoid therapy inc...

An 8-year retrospective analysis of invasive Aspergillus stomatitis in neutropenic patients with acute leukemia was performed to characterize the epidemiology and clinical features of the infection. Twelve cases of invasive Aspergillus stomatitis were identified with both clinicohistological and microbiological evidence, and the majority of cases were caused by Aspergillus flavus (10 [83%] of 1...