New guideline: Focus on the risk of infection in blood cancer patients!

New guideline: Focus on the risk of infection in blood cancer patients!

People with blood cancers face unique challenges, particularly when it comes to infection risks. Due to a weakened immune system, they are more susceptible to respiratory infections. A revised guideline summarizing the latest evidence on these infections over the last decade was recently published. The recommendations, which appeared in the journal “The Lancet Infectious Diseases” on August 27, 2025, come from the European Conference on Infections in Leukemia (ECIL) and were prepared by Prof. Dr. Marie von Lilienfeld-Toal was the first author, how news.rub.de reported.

The revised guideline covers various aspects, including the danger of individual viruses, diagnosis of infections, the need for hygiene measures and recommendations for therapy as well as vaccination strategies. It is particularly emphasized that patients with blood cancer have a significantly increased risk of respiratory infections after strong immunosuppressive therapies.

Recommended infection control measures

One of the central findings of the guideline is that influenza infections can be fatal in up to 10% of cases and that patients shed the virus for longer. The risk of becoming infected with SARS-CoV-2 also remains increased, although vaccinations often offer less protection in these cases. The revision was based on literature on respiratory viruses published between 2014 and 2024 as well as current clinical experience.

Recommended measures include specific infection control strategies and laboratory diagnostics. For influenza infections, vaccination with seasonal inactivated vaccines and early administration of antiviral therapies are recommended. However, general antiviral prophylaxis is not advocated. For respiratory syncytial virus (RSV), approved vaccines may be considered, while passive immunization is recommended for children under two years of age.

In addition, therapy with ribavirin and/or intravenous immunoglobulins is considered useful for patients after stem cell transplants. Supportive measures to improve immune function are also available. These recommendations are extremely relevant for practitioners, relatives and patients, as viral respiratory infections often originate from the environment and are therefore also important in outpatient clinics and general practitioners' practices deutschesgesundheitsportal.de.

Clinical context and individual patient cases

To underline the importance of this guideline, clinical case scenarios are also important. Current cases from the medical literature show that patients treated for blood cancers are often confronted with the complications of respiratory infections. An example is a 58-year-old patient with metastatic hepatic pancreatic cancer whose good general condition is at risk due to possible infections. Outpatient polychemotherapy according to the FOLFIRINOX regimen is carried out, with risk assessment for fever and infections in neutropenia being of particular importance. Here, prophylactic antibiotics represent an option to reduce mortality pmc.ncbi.nlm.nih.gov describes.

Adjusting empirical antibiotic therapy is essential because therapy should not be changed based solely on colonization status. It is also important to consider antibiotic resistance to maximize the effectiveness of oncological therapies and avoid complications.

Overall, it appears that targeted infection control and the application of the new guidelines are crucial for the treatment of patients with blood cancers. Preventive measures and individual therapeutic strategies play a key role in significantly improving the quality of life of this patient group.