Eine der häufigsten Komplikationen während der Therapie der Akuten Myeloischen Leukämie
(AML) sind Infektionen. Die lange Chemotherapie-assoziierte Neutropeniephase begünstigt
neben bakteriellen und viralen Infektionen insbesondere das Auftreten von Pilzinfektionen.
Da Infektionen mit einer erhöhten Morbidität und Mortalität verbunden sind, spielen
eine umgehende Diagnostik und Therapie sowie die medikamentöse Prophylaxe eine wichtige
Rolle.
Abstract
Infections represent one of the most frequent complications during therapy of acute
myeloid leukemia (AML). In addition to associated prolonged phases of neutropenia,
damage to the mucosal barrier by cytotoxic agents favors infections caused by endogenous
pathogens. The source often remains unknown with bacteremia being the most common
evidence of infection. Infections with gram-positive bacteria predominate, however,
infections with gram-negative bacteria more often lead to sepsis and death. Due to
prolonged neutropenia, patients with AML are furthermore at risk for invasive fungal
infections. Viruses, on the other hand, are rarely the cause of neutropenic fever.
Because of the limited inflammatory response in neutropenic patients, fever is often
the only sign of infection and therefore always represents a hematologic emergency.
Prompt diagnosis and initiation of an adequate anti-infective therapy are critical
to avoid progression to sepsis and possibly death.
Schlüsselwörter
akute myeloische Leukämie - neutropenisches Fieber - invasive Mykose
Keywords
acute myeloid leukemia - neutropenic fever - invasive fungal disease
