Infectious complications in 127 patients with hairy cell leukemia

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Abstract
Information regarding infectious complications was obtained on 127 patients with hairy cell leukemia who were diagnosed between March 1974 and April 1982. Forty‐seven patients (37%) had 111 documented infections (cultures positive), and 40 patients (31.5%) had 113 nondocumented infections (no culture results available, or cultures negative). The remaining 40 patients (31.5%) had no significant infections during the course of their disease. Patients without infection lived significantly longer than did patients who developed an infection (92% v 49% were alive at 4 years; P = .0012). Thirty‐three of the 47 patients with documented infection have died; 29 of an infectious problem and four of a noninfectious problem. There was also a statistically significant difference in actuarial survivals between the documented‐infection and nondocumented infection groups (P = .007). The two most common types of infection were bacteremia (30 episodes) and pneumonia (27 episodes). In the culture‐documented group with bacteremia, E coli and P aeruginosa caused ten and eight infections, respectively, and three infections were due to S aureus. There were eight systemic infections of nonbacterial origin; in five, the organism cultured was M kansasii, and three were fungal infections. Blood counts at the time of diagnosis were not correlated with subsequent development of infection. Patients with hairy cell leukemia have a significant susceptibility to infections that can affect morbidity and mortality. Many of the infectious complications encountered are those common in patients whose immune system is compromised; however, the occurrence of disseminated atypical mycobacterial disease requires a heightened awareness.