Infection management in hematological malignancies

Hematological malignancies encompass a group of diseases that often require intensive cytotoxic chemotherapy. These chemotherapy protocols can lead to prolonged neutropenia, increasing the risk of hospitalization and potentially fatal infections (1). The risk of infection varies among patients due to factors such as diagnosis, risk status, relapse/refractory condition, comorbidities (renal or liver failure, etc.), chemotherapy intensity, and the severity and duration of neutropenia. Severe and prolonged neutropenia is particularly common following myeloablative regimens in stem cell transplantation, induction protocols in acute leukemia, and salvage therapies in refractory/relapsed patients. In addition to neutropenia, chemotherapy also predisposes patients to infections by disrupting the mucosal barrier and causing disease-related immunosuppression. The disruption of the mucosal barrier allows colonizing microorganisms to invade, increasing the risk of invasive infections (2).