INFLUENZA AMONG HOSPITALIZED ADULTS WITH LEUKEMIA

Influenza is one of the most important respiratory diseases of mankind , yet scant data exist concerning the frequency and clinical course of influenza in severely immunocompromised adults. From October 1993 to September 1994, we cultured the respiratory secretions of all adults w ith leukemia who were hospitalized with an acute respiratory illness a t The University of Texas M.D. Anderson Cancer Center in Houston. Duri ng a 9-week period from 29 November 1993 to 29 January 1994, influenza virus type A (H3N2) was isolated from 15 (33%) of these 45 hospitaliz ed adults. Twelve (80%) of the eases of influenza were associated with pneumonia, and four patients (33%) with pneumonia died. Patients who died tended to have received chemotherapy more recently and to be more myelosuppressed. Autopsy examination in two cases revealed histopatho logic changes consistent with viral pneumonia. During community outbre aks, influenza is a frequent cause of serious respiratory disease in h ospitalized adults with leukemia. Effective prophylactic and therapeut ic regimens need to be defined for immunocompromised patients.