Exploring the association between alpha hemolytic streptococcal infection and intensive treatment outcomes in acute myeloid leukemia.

Abstract

Objective: To assess the prevalence of alpha hemolytic streptococcal (AHS) infections and related risk factors in patients with newly diagnosed acute myeloid leukemia (AML) undergoing consistent treatment. Study Design: Prospective study. Setting: Jinnah Teaching Hospital and DHQ Charsadda undergoing treatment from Hayatabad Medical Complex Peshawar. Period: June 2022 to February 2023. Material & Methods: AML patients were recruited and algorithmically followed for AHS infections. Core symptoms, diagnostic workups, differential diagnoses, and relevant treatments were assessed in this manner. Results: AHS caused 22% of bacteremic infections in 22% of patients, mostly by blood transmission (87%). After treatment, 32% recurred. AHS had a 60% mortality rate (P < 0.002). Age, precise induction timing, and high-dose cytarabine significantly enhanced AHS incidence (OR 2.0, 1.8–1.9, and 3.8, respectively). AHS infections increased hospital stays (P < 0.0002) and decreased long-term survival (OR 2.8; P < 0.001) and disease-free survival (OR 2.1; P 0.008) in bone marrow transplant patients. Conclusion: The first prospective study investigating AHS frequency in consistently treated individuals revealed increased rates with intensified AML therapy. AHS bacteremia is particularly likely in adults with prior cases and high-dose cytarabine usage.