INFECTION IN MYELODYSPLASTIC SYNDROMES BEFORE EVOLUTION INTO ACUTE NONLYMPHOBLASTIC LEUKEMIA

The frequencies, kinds, pathogens, and risk factors of infections in t he myelodysplastic syndromes (MDS) were analysed in 430 cases. The ove rall tendency was for one infectious episode per 1023.5 patient days. The frequency of infectious episodes was highest just after diagnosis of MDS when more than 4 episodes per 1000 patient days occurred. There after, the rate declined rapidly to about 0.3 episodes per 1000 patien ts days within 4 years. The most frequent infection was that of the re spiratory tract followed by sepsis and fever of unknown origin (FUO). Among the types of infection resulting in death, sepsis and FUO compri sed the highest proportion (40%) followed by respiratory tract infecti ons (39%). The most frequent pathogen observed was Staphylococcus bact eria. The significant multivariate risk factors for fatal infections w ere subtype, hemoglobin, dependence on red blood cell transfusion, age , and sex. A staging system was created using these five simple variab les at diagnosis.