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Neutropenic sepsis in patients with leukaemia, lymphoma, and solid organ tumours 

Neutropenic sepsis in patients with leukaemia, lymphoma, and solid organ tumours
Chapter:
Neutropenic sepsis in patients with leukaemia, lymphoma, and solid organ tumours
Author(s):

Simon M. Fox

, Angela M. Minassian

, Thomas Rawlinson

, and Brian J. Angus

DOI:
10.1093/med/9780198789987.003.0006
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date: 19 August 2019

Leukaemias, lymphomas, and solid organ tumours represent a widely diverse range of cancers. Until recently, the general approach to treating them was to administer cytotoxic anticancer drugs that damage proliferating cells by interfering with mitosis and cellular replication. A major disadvantage of this approach is the lack of specificity of cytotoxic drugs; they destroy actively dividing normal cells as well as malignant cells. As a result, achieving maximum tumour killing using high doses of these agents is often offset or prevented by collateral damage to normal tissues. Two common adverse effects are profound neutropenia, due to disruption of haematopoiesis in the bone marrow, and mucositis, resulting from injury to the gastrointestinal mucosal barrier. Mucositis potentiates the translocation of normal and colonizing gastrointestinal flora into the bloodstream. In the setting of neutropenia, where there is a paucity of effector cells to contain serious infections, bacteraemia may cause severe morbidity and mortality.

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