Malignant Causes of Fever, Including Hematologic and Lymphoid Malignancies

Fever is a common symptom in malignancies, particularly hematologic cancers like leukemia, lymphoma, and multiple myeloma. These conditions often trigger fever due to systemic inflammation, tumor burden, and immune dysregulation.

Hematologic Malignancies Associated with Fever

Leukemia

Leukemia patients frequently experience fever due to infections, cytokine release, and increased metabolic activity of malignant cells.

Lymphoma

Lymphomas, especially Hodgkin’s lymphoma, can present with persistent fevers as part of B symptoms, alongside night sweats and weight loss.

Multiple Myeloma

Multiple myeloma may cause fever due to underlying infections, given the impaired immune system function in affected individuals.

Pathophysiology of Fever in Malignancies

The mechanisms of fever in hematologic malignancies include:

• Inflammatory cytokine release (e.g., IL-6, TNF-alpha)
• Infections due to immunosuppression
• Tumor necrosis and systemic response

Diagnostic Approach

Workup for fever in malignancy involves complete blood count (CBC), inflammatory markers, imaging studies, and microbiological assessments to rule out infections.

Management Strategies

Treatment of fever in cancer patients focuses on managing the underlying malignancy, controlling infections with antibiotics, and supportive care such as hydration and antipyretics.