Predictors of development of pneumonia during chemotherapy-induced febrile neutropenia in patients with acute myelogenous leukemia.

IA Burney, G Favis, A Sorathia, T Siddiqui


We undertook a retrospective study to examine the patterns of pulmonary infiltrates, microbiological isolates and factors which might predict the development of pneumonia. Fifty-five patients with AML who developed febrile neutropenia after cytotoxic chemotherapy were evaluated. The neutropenia developed 8.4 days (D) after the start of therapy and was present for a duration of 10.9 D. 70% of these patients developed pulmonary infiltrates in the post chemotherapy period. 103 episodes (E) of neutropenia were complicated by pulmonary infiltrates in 51 E (48.5%). All pulmonary infiltrates were equated with pneumonia in these patients. Pneumonia started in a segmental distribution in the majority of E (30/51). Pneumonia was bilateral at onset in 24/51 E and unilateral in 27/51 patients. 35/51 E had bacteria isolated from the respiratory tract or blood. 44% of the bacteria were gram positive. Fungi were isolated on 20 occasions. Aspergillus was seen more commonly than the candida. Age, sex, type of chemotherapy, duration of neutropenia and the empiric antibiotic therapy did not predict the occurrence of pneumonia. The only two positive predictors of pneumonia were early onset of neutropenia (P 0.034) and an involved bone marrow (P

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Full conference title: 

39th meeting of the American Society for Haemotology
    • ASH 39th (1998)