Risk of pneumococcal septicaemia in patients with chronic lymphoproliferative malignancies

Abstract

Guidelines for the prevention of infection in patients with an absent or dysfunctionalspleen have recently been prepared.1 However, another group of patients (with intact spleens) is also particularly susceptible to such infections. Lymphoproliferative malignancies such as chronic lymphocytic leukaemia, myeloma, and low grade non-Hodgkin's lymphoma are associated with immune paresis.2 Such patients are often treated with corticosteroids, and a combination of these two factors renders them vulnerable to infections with encapsulated organisms such as Streptococcus pneumoniae. These infections have a high morbidity and mortality. Over a period of 16 months we found that pneumococcal sepsis was a far greater problem in patients with lymphoproliferative disorders than in patients who had had a splenectomy; we decided to investigate further. We studied all …