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Febril neutropenia

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https://www.readbyqxmd.com/read/28807922/are-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-adequate-for-the-management-of-febrile-neutropenia-answers-from-population-pharmacokinetic-modelling-and-monte-carlo-simulations
#1
Fekade Bruck Sime, Uwe Hahn, Morgyn S Warner, Ing Soo Tiong, Michael S Roberts, Jeffrey Lipman, Sandra L Peake, Jason A Roberts
Changes in the pharmacokinetics of piperacillin in febrile neutropenic patients have been reported to result in sub-optimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for haematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Non-parametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with Pmetrics® package for R...
August 14, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28804626/efficacy-and-safety-of-biosimilar-filgrastim-in-primary-and-secondary-prevention-of-febrile-neutropenia
#2
Leszek Kraj, Joanna Krawczyk-Lipiec, Joanna Górniewska, Grzegorz Orlik
Neutropenia and febrile neutropenia (FN) are among the most common side effects/complications of chemotherapy. The aim of the present study was to evaluate the practice of the use of biosimilar filgrastim in the primary and secondary prevention of FN, and assess its efficacy and safety. A multi-center, non-interventional epidemiological study of 170 cancer patients aged 23-82 years was conducted. Data were collected via a questionnaire completed based on medical documentation and patient examination over five chemotherapy visits...
August 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28798290/bradycardia-and-hypothermia-complicating-azithromycin-treatment
#3
Kerri Benn, Sam Salman, Madhu Page-Sharp, Timothy M E Davis, Jim P Buttery
BACKGROUND Azithromycin is a macrolide antibiotic widely used to treat respiratory, urogenital, and other infections. Gastrointestinal upset, headache, and dizziness are common adverse effects, and prolongation of the rate-corrected electrocardiographic QT interval and malignant arrhythmias have been reported. There are rare reports of bradycardia and hypothermia but not in the same patient. CASE REPORT A 4-year-old boy given intravenous azithromycin as part of treatment for febrile neutropenia complicating leukemia chemotherapy developed hypothermia (rectal temperature 35...
August 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28782407/evaluation-of-pegfilgrastim-use-at-an-academic-medical-center
#4
Kathy Tang, Alison Duffy, Steven Gilmore
Purpose Pegfilgrastim is indicated to reduce the risk of febrile neutropenia. As a cost-savings initiative, Pegfilgrastim Process Guidelines were developed and implemented at a large, academic teaching institution to improve appropriate use of pegfilgrastim and to decrease costs of outpatient infusion center administration by deferring doses to home self-administration for eligible patients. Methods A retrospective medical record review was conducted post-implementation of the Pegfilgrastim Process Guideline to evaluate the use of pegfilgrastim and to assess the safety and efficacy of transferring pegfilgrastim orders from outpatient infusion center to home administration for eligible patients...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28776351/the-utility-of-preliminary-patient-evaluation-in-a-febrile-respiratory-infectious-disease-unit-outside-the-emergency-department
#5
Jun Sik Kang, Byung Woo Jhun, Hee Yoon, Seong Mi Lim, Eunsil Ko, Joo Hyun Park, Sung Yeon Hwang, Se Uk Lee, Tae Rim Lee, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo
A febrile respiratory infectious disease unit (FRIDU) with a negative pressure ventilation system was constructed outside the emergency department (ED) of the Samsung Medical Center in 2015, to screen for patients with contagious diseases requiring isolation. We evaluated the utility of the FRIDU during 1 year of operation. We analyzed 1,562 patients who were hospitalized after FRIDU screening between August 2015 and July 2016. The level of isolation recommended during their screening at the FRIDU was compared with the level deemed appropriate given their final diagnosis...
September 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28776170/viridans-group-streptococci-bloodstream-infections-in-neutropenic-adult-patients-with-hematologic-malignancy-single-center-experience
#6
J Radocha, P Paterová, A Zavřelová, B Víšek, F Gabalec, H Žemličková, P Žák
Viridans group streptococci bloodstream infections (VGS BSI) remain a significant cause of mortality and morbidity in patients with severe neutropenia. The goal of our study was to evaluate clinical course and microbiological susceptibility of VGS BSI at our center. Retrospective analysis of all microbiologically documented bloodstream infections caused by VGS during the 9-year time period (from January 2006 until December 2014) was carried out. Only patients with severe neutropenia (< 500/μL) were included in the study...
August 3, 2017: Folia Microbiologica
https://www.readbyqxmd.com/read/28774489/-normal-tissue-tolerance-to-external-beam-radiation-therapy-bone-marrow-and-cortical-bone-structures
#7
A Schernberg, C Hennequin
In patients undergoing external radiation therapy, bone marrow and cortical bone structures are all often neglected as organs at risk. Still, from increased febrile neutropenia risk in patients undergoing chemoradiation for a pelvic tumour to increased risk of vertebral fracture when undergoing hypofractioned stereotactic radiotherapy of a spinal metastasis, adverse effects are frequent and sometimes serious. This literature review first defines the rules for contouring these structures, then the dose constraints currently recommended...
July 31, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28771961/phase-i-study-of-pemetrexed-and-concurrent-radiotherapy-for-previously-untreated-elderly-patients-with-locally-advanced-non-squamous-non-small-cell-lung-cancer
#8
Shinnosuke Takemoto, Yoichi Nakamura, Minoru Fukuda, Hiroaki Senju, Hiroshi Gyotoku, Hirokazu Taniguchi, Midori Shimada, Takaya Ikeda, Hiroyuki Yamaguchi, Katsumi Nakatomi, Nobuyuki Hayashi, Hiroshi Soda, Hiroshi Mukae
BACKGROUND: Chemoradiotherapy is the standard treatment for locally advanced non-small cell lung cancer (NSCLC); however, it is disputed whether this treatment is suitable for patients aged ≥75. This study was conducted to determine the maximum tolerated dose (MTD) of pemetrexed for use in concurrent radiotherapy for elderly patients with locally advanced non-squamous NSCLC. METHODS: The eligibility criteria were as follows: aged ≥75 with inoperable stage IIIA or IIIB non-squamous NSCLC, no history of chemotherapy or radiotherapy, a performance status of 0 or 1, and adequate organ function...
August 3, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28768977/the-first-case-of-pseudomonas-aeruginosa-bacteremic-pneumonia-in-a-cancer-patient-receiving-pegfilgrastim
#9
Fujiko Morita, Yuji Hirai, Kiyozumi Suzuki, Yuki Uehara, Kazunori Mitsuhashi, Masahito Takahashi, Sumio Watanabe, Toshio Naito
A single dose of pegfilgrastim or the daily administration of colony-stimulating factors can be used to prevent febrile neutropenia. This may delay the detection of rapidly progressive infections among cancer patients undergoing chemotherapy. We report a case of Pseudomonas aeruginosa bacteremic pneumonia that occurred in a patient receiving pegfilgrastim.
2017: Internal Medicine
https://www.readbyqxmd.com/read/28766851/folate-deficiency-in-north-indian-children-undergoing-maintenance-chemotherapy-for-acute-lymphoblastic-leukemia-implications-and-outcome
#10
Nirmalya Roy Moulik, Archana Kumar, Suraksha Agrawal, Abbas Ali Mahdi
BACKGROUND: Treatment-related toxicity and mortality are not uncommon during maintenance chemotherapy for childhood acute lymphoblastic leukemia (ALL), especially in the low- and middle-income countries (LMIC). Undernutrition and micronutrient deficiencies are commonly seen in children from LMICs undergoing treatment for ALL. The present study examines the prevalence and clinical implications of folate deficiency in north Indian children with ALL during the maintenance phase of treatment in view of prolonged antifolate treatment and high population prevalence of folate deficiency...
August 2, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28766263/a-phase-ii-study-of-combination-therapy-with-oral-s-1-and-cisplatin-in-elderly-patients-with-advanced-gastric-cancer
#11
Yusuke Sasaki, Satoru Iwasa, Shunsuke Okazaki, Masahiro Goto, Yasushi Kojima, Atsushi Naganuma, Kengo Nagashima, Yushi Nagai, Hidekazu Hirano, Yoshitaka Honma, Atsuo Takashima, Ken Kato, Tetsuya Hamaguchi
BACKGROUND: A combination of S-1 and cisplatin is recognized as one of the standard first-line chemotherapy regimens for patients with advanced gastric cancer. However, demographic analyses of pivotal phase III studies have showed that only a minority of treated patients were aged 76 years or older. The purpose of this phase II study was to evaluate the safety and efficacy of combination therapy with S-1 and cisplatin in elderly patients with chemotherapy-naive advanced gastric cancer...
August 1, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28764837/supportive-treatments-for-patients-with-cancer
#12
Karin Jordan, Petra Feyer, Ulrike Höller, Hartmut Link, Bernhard Wörmann, Franziska Jahn
BACKGROUND: For the treatment of patients with cancer to be successful and well-tolerated, the complications and side effects of the disease and its treatment must be treated and limited as far as possible. Summarized recommendations based on the constantly increasing evidence in the area of supportive care must be defined, standardized, and communicated. METHODS: We systematically reviewed the literature on the topics of anemia, neutropenia, nausea/vomiting, diarrhea, oral mucositis, skin toxicity, and peripheral neurotoxicity induced by cancer treatment, as well as osseous complications, extravasation, and side effects of radiotherapy...
July 10, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28761968/a-retrospective-study-of-amrubicin-monotherapy-for-the-treatment-of-relapsed-small-cell-lung-cancer-in-elderly-patients
#13
Hisao Imai, Tomohide Sugiyama, Tomohiro Tamura, Hiroyuki Minemura, Kyoichi Kaira, Kenya Kanazawa, Hiroshi Yokouchi, Takashi Kasai, Takayuki Kaburagi, Koichi Minato
PURPOSE: Amrubicin is one of the most active chemotherapeutic drugs for small cell lung cancer (SCLC). Previous studies reported its effectiveness and severe hematological toxicity. However, the efficacy of amrubicin monotherapy in elderly patients with SCLC has not been described. The objective of this study was to investigate the feasibility of amrubicin monotherapy in elderly patients and its efficacy for relapsed SCLC. METHODS: A retrospective cohort study design was used...
July 31, 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/28761897/the-dose-dependent-efficacy-of-cefepime-in-the-empiric-management-of-febrile-neutropenia-a-systematic-review-and-meta-analysis
#14
Nikolaos Andreatos, Myrto Eleni Flokas, Anna Apostolopoulou, Michail Alevizakos, Eleftherios Mylonakis
BACKGROUND: Despite reports questioning its efficacy, cefepime remains a first-line option in febrile neutropenia. We aimed to re-evaluate the role of cefepime in this setting. METHODS: We searched the PubMed and EMBASE databases to identify randomized comparisons of (1) cefepime vs alternative monotherapy or (2) cefepime plus aminoglycoside vs alternative monotherapy plus aminoglycoside, published until November 28, 2016. RESULTS: Thirty-two trials, reporting on 5724 patients, were included...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28760399/tas-102-plus-bevacizumab-for-patients-with-metastatic-colorectal-cancer-refractory-to-standard-therapies-c-task-force-an-investigator-initiated-open-label-single-arm-multicentre-phase-1-2-study
#15
Yasutoshi Kuboki, Tomohiro Nishina, Eiji Shinozaki, Kentaro Yamazaki, Kohei Shitara, Wataru Okamoto, Takeshi Kajiwara, Toshihiko Matsumoto, Takahiro Tsushima, Nobuo Mochizuki, Shogo Nomura, Toshihiko Doi, Akihiro Sato, Atsushi Ohtsu, Takayuki Yoshino
BACKGROUND: In patients with heavily treated metastatic colorectal cancer, TAS-102-a combination of trifluridine and tipiracil-has shown a significant overall survival benefit compared with placebo. In preclinical models, TAS-102 plus bevacizumab has shown enhanced activity against colorectal cancer xenografts compared with that for either drug alone. In this phase 1/2 study, we assessed the activity and safety of TAS-102 plus bevacizumab. METHODS: We did this investigator-initiated, open-label, single-arm, multicentre, phase 1/2 trial of TAS-102 plus bevacizumab in four cancer centres in Japan...
July 28, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28758610/reducing-second-gram-negative-antibiotic-therapy-on-pediatric-oncology-and-hematopoietic-stem-cell-transplantation-services
#16
Rachel L Wattier, Emily R Levy, Amit J Sabnis, Christopher C Dvorak, Andrew D Auerbach
OBJECTIVE To evaluate interventions to reduce avoidable antibiotic use on pediatric oncology and hematopoietic stem cell transplantation (HSCT) services. DESIGN Interrupted time series. SETTING Academic pediatric hospital with separate oncology and HSCT services. PARTICIPANTS Children admitted to the services during baseline (October 2011-August 2013) and 2 intervention periods, September 2013-June 2015 and July 2015-June 2016, including 1,525 oncology hospitalizations and 301 HSCT hospitalizations. INTERVENTION In phase 1, we completed an update of the institutional febrile neutropenia (FN) guideline for the pediatric oncology service, recommending first-line β-lactam monotherapy rather than routine use of 2 gram-negative agents...
July 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28753384/cabazitaxel-versus-docetaxel-as-first-line-therapy-for-patients-with-metastatic-castration-resistant-prostate-cancer-a-randomized-phase-iii-trial-firstana
#17
Stéphane Oudard, Karim Fizazi, Lisa Sengeløv, Gedske Daugaard, Fred Saad, Steinbjørn Hansen, Marie Hjälm-Eriksson, Jacek Jassem, Antoine Thiery-Vuillemin, Orazio Caffo, Daniel Castellano, Paul N Mainwaring, John Bernard, Liji Shen, Mustapha Chadjaa, Oliver Sartor
Purpose In patients with metastatic castration-resistant prostate cancer (mCRPC), overall survival (OS) is significantly improved with cabazitaxel versus mitoxantrone after prior docetaxel treatment. FIRSTANA ( ClinicalTrials.gov identifier: NCT01308567) assessed whether cabazitaxel 20 mg/m(2) (C20) or 25 mg/m(2) (C25) is superior to docetaxel 75 mg/m(2) (D75) in terms of OS in patients with chemotherapy-naïve mCRPC. Patients and Methods Patients with mCRPC and Eastern Cooperative Oncology Group performance status of 0 to 2 were randomly assigned 1:1:1 to receive C20, C25, or D75 intravenously every 3 weeks plus daily prednisone...
July 28, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28752564/oral-versus-intravenous-fluoropyrimidines-for-colorectal-cancer
#18
REVIEW
Fiona Chionh, David Lau, Yvonne Yeung, Timothy Price, Niall Tebbutt
BACKGROUND: Patients prefer oral to intravenous (IV) palliative chemotherapy, provided that oral therapy is not less effective. We compared the efficacy and safety of oral and IV fluoropyrimidines for treatment of colorectal cancer (CRC). OBJECTIVES: To compare the effects of oral and IV fluoropyrimidine chemotherapy in patients treated with curative or palliative intent for CRC. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 5), along with OVID MEDLINE, OVID Embase, and Web of Science databases, in June 2016...
July 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28750112/febrile-neutropenia
#19
Krish Patel, Howard Jack West
No abstract text is available yet for this article.
July 27, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28748605/management-of-chemotherapy-induced-febrile-neutropenia-in-pediatric-oncology-patients-a-north-american-survey-of-pediatric-hematology-oncology-and-pediatric-infectious-disease-physicians
#20
Rochelle R Maxwell, Dana Egan-Sherry, Jonathan B Gill, Michael E Roth
BACKGROUND: Chemotherapy-induced febrile neutropenia (FN) is traditionally managed with hospital admission for parenteral antibiotics until neutropenia resolves. Recent studies have explored risk stratification and the safety of managing "low-risk" patients as outpatients. Few studies have directly assessed pediatric provider preferences for managing FN. PROCEDURE: We conducted a survey of practicing US and Canadian pediatric hematology/oncology (PHO) and pediatric infectious disease (PID) physicians to assess their FN management preferences using case scenarios with varying risk profiles...
July 27, 2017: Pediatric Blood & Cancer
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