Abstract
Cancer, chemotherapy, and infections all together make changes in blood rheology and may affect the defense mechanisms by changing the thrombocyte function and endothelial cell. We have examined changes of blood rheology on plasma viscosity to put on probable following criteria for starting the treatment of febrile neutropenia immediately. A total of 27 postchemotherapy patients (16 males and 11 females) with febrile neutropenia diagnosed according to international guidelines have been included into the study. The plasma viscosity of the patients whose febrile neutropenia has been successfully treated was also measured to assess the impact of the duration of neutropenia on viscosity. The plasma viscosities of the patients were significantly higher during neutropenic episode than in nonneutropenic state (P = 0.006) except for alkaline phosphatase. All study parameters, particularly acute phase reactants, were statistically similar during both states. In the correlation of analysis with study parameters and stages, significant correlation was not observed between plasma viscosity alteration and leukocyte-neutrophil alteration, also other study parameters. We have demonstrated significantly elevated plasma viscosity in our patients during febrile neutropenic episode. Despite normal values of various parameters known to trigger plasma viscosity, particularly fibrinogen, it can be easily argued that the main mechanism may be the endothelial injury during infectious process and immune response mediated microcirculatory blood flow alterations.
Highlights
Infectious diseases are important factors of morbidity and mortality in patients with hematological malignancies
Primary empiric carbapenem was administered to 11 acute myeloblastic leukemia (AML) patients, 3 acute lymphoblastic leukemia (ALL) patients and 7 patients with cancer of solid organ
It has previously been reported that plasma viscosity is valuable and can be a surrogate marker of erythrocyte sedimentation rate and the other acute-phase reactants [8]
Summary
Infectious diseases are important factors of morbidity and mortality in patients with hematological malignancies. Even though cancer is a risk factor for infection, neutropenia has been regarded as the main factor for the development of infections in patients undergoing chemotherapy. There are so many new developments on diagnosis of infections and antimicrobial treatments, death caused by infections secondary to neutropenia is so common in acute and chronic leukemia patients. For the prevention of infection, early diagnosis and early treatment of infection become important in patients with cancer. Chemotherapy, and infections (all together) make changes in blood rheology and may affect the defense mechanisms by changing the thrombocyte function and endothelial cell [1]. Abnormalities in blood rheology might play an important role in the pathogenesis of organ failure in febrile neutropenic patients by damaging microvascular blood flow [2]
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