Abstract
Recently, incidence of severe infection in leukemia has increased since the combination therapy of multiple antileukemic agents was introduced. These antileukemic agents have side-effect of bone marrow suppression which causes severe neutropenia. The relationship among median leukocyte count during febrile episode (>38°C), duration of leukopenia (<100/mm3) and prognosis and also the relationship between monocyte count and prognosis of infection were studied. A high mortality rate was observed despite relative large dose of antibiotics in case the median neutrophil count during febrile episode was below 100/mm3 and the duration of leukopenia (<100/mm3) prolonged over 8 days. When sepsis had occurred, median neutrophil conut during febrile episode seemed to be necessary more than 500/mm3 to cure the sepsis. The patients who died of sepsis rarely developed increment of monocyte count over 100/mm3 after onset of febrile episode. Since transient severe neutropenia in leukemia has become very frequent with modern therapy and we have never had specific drugs to kill only leukemic cells yet, other procedures to prevent infection, such as germ free isolator and/or leukocyte transfusion should be applied in addition to antibiotics as supportive care.
