K. Hubel et al., Suppressed neutrophil function as a risk factor for severe infection aftercytotoxic chemotherapy in patients with acute nonlymphocytic leukemia, ANN HEMATOL, 78(2), 1999, pp. 73-77
Severe infections are a major problem in patients suffering from acute nonl
ymphocytic leukemia (ANLL) undergoing myeloablative chemotherapy. Possible
factors leading to infectious complications in these patients are suppresse
d immune defense mechanisms existing prior to therapy, including those invo
lving the neutrophil granulocyte department. In this study we investigated
whether neutrophil function as measured by oxidative burst and phagocytosis
before the start of treatment correlates with the severity of infection af
ter therapy. Forty-four patients were included, 27 men and 17 women. Their
median age was 46 years (range 20-70 years). According to the development o
f infectious complications the patients were assigned retrospectively to gr
oup 1 (no or only mild infections, n=29) or to group 2 (severe infection or
death due to infection, n=15). The phagocytic activity was significantly r
educed in group 2 as compared with group 1 [113.7+/-13.7 (SEM) vs 170.0+/-1
9.2, mean channel fluorescence; p = 0.04]. In contrast, the oxidative burst
as measured by FMLP stimulation was pronounced but not significantly enhan
ced in group 2 (24.8+/-6.1 vs 14.5+/-3.4, mean channel fluorescence). In co
nclusion, patients with severe infections after chemotherapy might already
have preactivated neutrophils with suppressed function prior to treatment.
Thus, evaluating function parameters could help to estimate the individual
risk of infection for a patient with ANLL.