TREATMENT OF INFECTIONS IN ACUTE LEUKEMIA S

Background: Infections are the major cause for treatment failure in ac ute leukemias. They mostly present as fever of unknown origin (FUO), a smaller but prognostically unfavorable group are pneumonias. The effe ctive management of infectious complications requires a symptom and re sponse adapted interventional strategy. Therapeutical Approach: In cas e of FUO standard therapy consists of the two drug combination of amin oglycoside plus acylaminopenicillin or third generation cephalosporine . In case of non-response carbapenems and a glycopeptide should be app lied and a systemic antifungal treatment must be initiated. In pneumon ia amphotericin B should be added to antibiotics already initially. Po tent single agents with a broad spectrum of activity as well as new an tifungal drugs provide attractive perspectives for future evaluations. Conclusions: By a consequent step-wise escalating interventional trea tment strategy infections in patients with acute leukemias can be succ essfully treated.