Infections in Cancer Patients


JN Greene
Published by Marcel Dekker, Inc. (2004)
ISBN:  0-8247-5437-9  522 pages plus index


Infections in Cancer Patients is a comprehensive and extremely detailed edited volume (first edition), which holds the premise that infections in cancer are predictable. Since infections are a major cause of morbidity and mortality in the patient with cancer, being able to predict, recognise early, identify and manage them is the aim of the book.

Distinct immunodeficiencies are related to specific malignancies and their treatment, resulting in predictable opportunistic infections. 

Description is made of the major immune deficits inherent in each malignancy described, as well as how the malignancy and its therapy alters the immune system over time and leads to anatomical changes that predispose to the changing spectrum of pathogens. 

The book outlines the periods of vulnerability associated with chemotherapy regimes, the ensuing neutropenia and cell mediated immune deficiencies.  Consequently anti-microbial therapy can be altered to reflect the changes in the predominant pathogen expected. 

The introductory chapters outline mechanisms of host defence and the composition of what is normal microbial flora in various sites of the body. 

It then goes on to look at 10 distinct types of haematological lymphoreticular malignancies, detailing ALL, AML, Hairy cell leukaemia, CLL, CML, Myelodysplastic Syndromes, Multiple Myeloma, Hodgkin’s and Non-Hodgkin’s Lymphomas as well as infectious complications associated with stem cell transplant recipients. 

The chapters that follow are related to infectious complications of the following solid tumour malignancies; brain, head and neck, lung, breast, gastrointestinal, liver and biliary tract, neuroendocrine, bladder and kidney, gynaecological, sarcomas and cutaneous malignancies.

The next major section in the book covers system-specific infections, describing central nervous system, pulmonary, cardio-vascular, gastrointestinal, genitourinary, bone, joint and soft tissue infections, and then skin infections.

The book goes on to describe the infectious complications of cancer treatment that is not chemotherapy, specifically chapters on radiation therapy, surgery and then an interesting chapter on catheter related infections. 

There is a major section exploring unique infections in cancer patients (fungal and parasitic).  Also in this section is a short chapter on HIV related malignancies.

The final section assesses the best available evidence for measures to avert infections, including anti-microbial prophylaxis and vaccination, and analyses methods of handling fungal and parasitic infections. 

The book has 45 authors, 39 of whom are U.S. clinicians and researchers. It is edited by John Green who is Chief of Infectious diseases at the H Lee Moffitt Cancer Center and professor of medicine at the University of South Florida. 

The book is well-organised and easy-to-read.  It is well-referenced and has an evidence-based approach. 

Infections in Cancer Patients would be a good resource to have accessible in oncology wards and outpatients departments.

Margherita Nicoletti
Clare Holland House, ACT

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