Prevention and treatment of infections

Author: Dipl.-Biol. Maria Yiallouros, Gesche Tallen, MD, PhD, erstellt am: 2009/07/29, Editor: PD Dr. med. Gesche Tallen, Reviewer: Prof. Dr. med. Dr. h.c. Günter Henze, English Translation: Hannah McRae, Last modification: 2014/05/26

Cancer patients are prone to infection both following surgery and due to the bone-marrow damaging effects of chemotherapy and radiation, since their immune system is suppressed during anticancer treatment. Therefore, even pathogens that are harmless under normal circumstances can cause serious infectious complications.

Bacteria, viruses, and fungi can easily enter the body and rapidly multiply. The risk of infection is particularly high about eight to fourteen days after treatment with cytostatic agents, because the number of granulocytes (a subgroup of white blood cells that is particularly important for defence against pathogens) is often very low (less than 500 to 1,000 granulocytes per microliter of blood). This reduced number of granulocytes is also known as "neutropenia" and often associated with fever.

Furthermore, the so-called mucocutaneous barriers, a complex arrangement of specialized cells of the skin and the respiratory, gastrointestinal and genitourinary mucosa functioning to protect the body from invading pathogens, are often disrupted in children and adolescents with cancer. This disruption is due to their underlying disease and its treatment. It provides a major portal of invasion for various, such as bacterial or fungal pathogens.

Infections in immunocompromised children and adolescents are considered life threatening. Therefore, prevention and treatment of infections in childhood cancer patients is crucial for their good outcomes.

By continuously improving the supportive care regimens during the last three decades, the previously high infection-related morbidity and mortality rates in childhood cancer patients were considerably reduced. As a result, the overall survival rates of children and teenagers with cancer have increased significantly.

Basisliteratur

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