Malignant Causes of Fever: Hematologic and Lymphoid Malignancies

Fever is a common symptom in various hematologic and lymphoid malignancies. It can arise due to tumor-associated inflammation, cytokine release, or infection related to immunosuppression.

Understanding Fever Mechanisms in Malignancies

Fever associated with malignancies is often a paraneoplastic manifestation. Various mechanisms contribute:

• Cytokine-Induced Fever: Tumor cells release pro-inflammatory cytokines such as IL-6 and TNF-α, triggering fever.
• Neoplastic Cell Breakdown: Rapid tumor cell turnover can lead to an inflammatory response, elevating body temperature.
• Infection-Induced Fever: Immunosuppression due to chemotherapy or malignancy itself predisposes patients to infections.

Hematologic Malignancies and Fever

Several blood cancers commonly present with fever:

• Leukemia: Acute leukemias often cause fever due to cytokine release and secondary infections.
• Lymphomas: Hodgkin and non-Hodgkin lymphomas exhibit fever in their systemic symptoms, known as 'B symptoms.'
• Multiple Myeloma: Infections due to impaired immune function frequently lead to fever in affected patients.

Diagnostic Approach

Evaluating fever in hematologic malignancies requires:

• Complete blood count (CBC) with differential
• Bone marrow biopsy
• Serum cytokine analysis
• Imaging studies (CT, PET scans)

Management Strategies

Treatment focuses on underlying malignancy and symptom relief:

• Targeted Therapy: Precision treatments addressing specific cancer pathways.
• Antipyretics: Fever-reducing medications such as acetaminophen.
• Antibiotics: Infection control in immunocompromised patients.