Patients with haematological malignancies

In patients receiving chemotherapy for haematological malignancy, the risk of infection depends on:

• the type of malignancy (eg lymphoma, leukaemia, myeloma)
• the treatment regimen (particularly regimens containing fludarabine and monoclonal or biological therapies [eg rituximab, small-molecule inhibitors such as tyrosine kinase inhibitors])
• the severity and duration of neutropenia
• patient factors such as age and comorbidities.

For recommendations for antimicrobial prophylaxis according to cancer treatment protocols, see the eviQ Cancer Treatments Online website (choose ‘Haematology and BMT’, then the type of cancer and chemotherapy regimen, then ‘Clinical information’).

Antimicrobial prophylaxis reduces the risk of infection; however, infection can occur despite prophylaxis. Adherence to antimicrobial prophylaxis increases efficacy. Nonpharmacological preventive measures (including infection control, diet and lifestyle strategies) also reduce the risk of infection—see the guidelines listed in Further reading.