REVIEW article
Front. Oncol.
Sec. Hematologic Malignancies
This article is part of the Research TopicInfections in Hematology: Advances in Diagnosis, Management, and Prevention in Benign and Malignant DisordersView all 5 articles
Immune Dysregulation in Hairy Cell Leukemia: A Predisposing Factor for Opportunistic Legionella pneumophila Infections
Provisionally accepted
- Zunyi Medical University, Zunyi, China, Zunyi, China
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Patients with Hairy Cell Leukemia (HCL) are highly susceptible to infections due to impaired immune function, and Legionella pneumophila (Lp) infection—though rare—can be a life-threatening complication. This case report focuses on the diagnostic and therapeutic challenges of Lp infection in an immunocompromised HCL patient. Key findings include: (1) the failure of traditional diagnostic methods (e.g., sputum culture, blood culture) to identify the pathogen, while metagenomic next-generation sequencing (mNGS) confirmed Lp infection; (2) the need for timely adjustment of antibiotic regimens (switching from azithromycin to moxifloxacin) after pathogen confirmation; and (3) the clinical warning that HCL patients with persistent pancytopenia require careful balancing of chemotherapy and infection control. This report emphasizes the value of mNGS in diagnosing atypical infections in 2 immunocompromised patients and provides practical insights for clinical decision-making.
Keywords: Hairy cell leukemia, immunocompromised, Legionella pneumophila, mNGS (metagenomic next-generation sequencing), Pathogen Metagenomics
Received: 10 Sep 2025; Accepted: 29 Dec 2025.
Copyright: © 2025 Yu, An, Zhang, Gu and Ou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yangyao Ou
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