CHEMOTHERAPY SCHEDULE AND BACTEREMIAS IN ADULT PATIENTS WITH ACUTE-LEUKEMIA

In a study undertaken to evaluate fluoroquinolone prophylaxis in afebr ile granulocytopenic patients, an unexpected association between chemo therapy schedule and a later development of bacteremia -during the sub sequent febrile neutropenic episodes- was found. Twenty five febrile n eutropenic episodes consecutive to chemotherapy for acute leukemia wer e studied. Patients received either etoposide and mitoxantrone or cita rabine -in standard, intermediate or high doses- combined with daunomi cin or mitoxantrone. Microbiologic data analysis showed an increased i ncidence of bacteremia with combined anthracycline and intermediate or high dose citarabine administration, when compared to etoposide and m itoxantrone use (p = 0.000387). Both groups developed similarly fast a nd severe neutropenias and equivalent grades of digestive mucositis. C hemotherapy schedule was the only factor associated with a consecutive bacteremia -or not- during the subsequent neutropenic episode. We con clude that effects other than bone marrow aplasia and digestive mucosi tis may be relevant in infectious susceptibility induced by cytostatic drugs.