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


  • Sadaf Nasir Jinnah Medical College, Peshawar.
  • Ayesha Noor Quetta Institute of Medical Sciences, Quetta
  • Uzma Ali Provincial Headquarter Hospital, Gilgit.
  • Amna Khalid Jinnah Medical College, Peshawar.
  • Namra Yunus Fatima Memorial College of Medicine and Dentistry, Lahore.
  • Saadia Anwar Jinnah Medical College, Peshawar.




Alpha Hemolytic Streptococcal Infection, Acute Myeloid Leukemia (AML), Cytarabin, Intensive Treatment Outcomes, Therapy


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.

Author Biographies

Sadaf Nasir, Jinnah Medical College, Peshawar.

MBBS, M.Phil (Microbiology), Assistant Professor Pathology, 

Ayesha Noor, Quetta Institute of Medical Sciences, Quetta

MBBS, M.Phil (Hematology, Associate Professor Pathology, 

Uzma Ali, Provincial Headquarter Hospital, Gilgit.

MBBS, M.Phil (Microbiology), Consultant Pathologist Pathology, 

Amna Khalid, Jinnah Medical College, Peshawar.

MBBS, M.Phii (Histopathology), Senior Lecturer Pathology, 

Namra Yunus, Fatima Memorial College of Medicine and Dentistry, Lahore.

MBBS, M.Phil (Microbiology), Assistant Professor Pathology, 

Saadia Anwar, Jinnah Medical College, Peshawar.

BDS, M.Phil (Physiology), Senior Lecturer Physiology,