Immunotherapy of gram-negative infections in oncological patients.
While it is widely recognized that gram-negative bacteria (GNB) are a leading cause of morbidity and mortality among patients whose immune defenses are compromised both by their underlying malignancy as well as by its treatment, efforts to prevent or to treat such infections by immunological means have been hampered for several reasons. First, the natural anatomical barriers are often disrupted either by the tumor itself, by the chemotherapeutic agents, or, as recognized more recently, by viral (herpetic) or fungal infections, so that entrance of the gram-negative flora into the host tissue and blood stream is greatly facilitated. Efforts to diminish the bacterial load by means of oral decontamination, be it selective or not, to prevent such ingress have brought limited success. Second, active immunization is not likely to elicit a useful response in these patients, so that mainly passive immunotherapy has been considered and studied. However, since the most immunocompromised cancer patients are very often leucopenic, the opsono-phagocytic function of passively administered antibodies is not likely to help the patients to get rid of the invading gram-negative bacteria. This latter observation has been particularly well established in the case of Pseudomonas aeruginosa infections in leukemic patients (Young LS, Stevens P, Ingram J. J Clin Invest 1975, 56, 850-861).
Glauser
M P
MP
Department of Internal Medicine, University Medical Center, Lausanne, Switzerland.
D001424:Bacterial Infections / Q000628:therapy*; D006090:Gram-Negative Bacteria; D006801:Humans; D007167:Immunotherapy; D009369:Neoplasms / Q000150:complications*