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Febril neutropenia

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https://www.readbyqxmd.com/read/29781056/phase-ib-study-of-pevonedistat-a-nedd8-activating-enzyme-inhibitor-in-combination-with-docetaxel-carboplatin-and-paclitaxel-or-gemcitabine-in-patients-with-advanced-solid-tumors
#1
A Craig Lockhart, Todd M Bauer, Charu Aggarwal, Carrie B Lee, R Donald Harvey, Roger B Cohen, Farhad Sedarati, Tsz Keung Nip, Hélène Faessel, Ajeeta B Dash, Bruce J Dezube, Douglas V Faller, Afshin Dowlati
Purpose This phase Ib study (NCT01862328) evaluated the maximum tolerated dose (MTD), safety, and efficacy of pevonedistat in combination with standard-of-care chemotherapies in patients with solid tumors. Methods Patients received pevonedistat with docetaxel (arm 1, n = 22), carboplatin plus paclitaxel (arm 2, n = 26), or gemcitabine (arm 3, n = 10) in 21-days (arms 1 and 2) or 28-days (arm 3) cycles. A lead-in cohort (arm 2a, n = 6) determined the arm 2 carboplatin dose. Dose escalation proceeded via continual modified reassessment...
May 21, 2018: Investigational New Drugs
https://www.readbyqxmd.com/read/29778788/maintaining-dose-intensity-of-adjuvant-chemotherapy-in-older-patients-with-breast-cancer
#2
Rahul Ladwa, Timothy Kalas, Shivanshan Pathmanathan, Natasha Woodward, David Wyld, Jasotha Sanmugarajah
INTRODUCTION: Maintaining the relative dose intensity (RDI) of adjuvant chemotherapy at ≥ 85% has been associated with improved treatment outcomes in early-stage breast cancer (ESBC). Increasing evidence has suggested that patients aged ≥ 65 years can maintain the optimal RDI for standard chemotherapy regimens. The present study investigated the RDI of newer adjuvant chemotherapy regimens in this demographic. PATIENTS AND METHODS: We retrospectively analyzed the data from 281 patients aged ≥ 65 years with a diagnosis of ESBC who had received adjuvant chemotherapy across 3 sites in Queensland, Australia from 2010 to 2015...
April 28, 2018: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29778738/risk-adapted-therapy-for-young-children-with-medulloblastoma-sjyc07-therapeutic-and-molecular-outcomes-from-a-multicentre-phase-2-trial
#3
Giles W Robinson, Vasilisa A Rudneva, Ivo Buchhalter, Catherine A Billups, Sebastian M Waszak, Kyle S Smith, Daniel C Bowers, Anne Bendel, Paul G Fisher, Sonia Partap, John R Crawford, Tim Hassall, Daniel J Indelicato, Frederick Boop, Paul Klimo, Noah D Sabin, Zoltan Patay, Thomas E Merchant, Clinton F Stewart, Brent A Orr, Jan O Korbel, David T W Jones, Tanvi Sharma, Peter Lichter, Marcel Kool, Andrey Korshunov, Stefan M Pfister, Richard J Gilbertson, Robert P Sanders, Arzu Onar-Thomas, David W Ellison, Amar Gajjar, Paul A Northcott
BACKGROUND: Young children with medulloblastoma have a poor overall survival compared with older children, due to use of radiation-sparing therapy in young children. Radiotherapy is omitted or reduced in these young patients to spare them from debilitating long-term side-effects. We aimed to estimate event-free survival and define the molecular characteristics associated with progression-free survival in young patients with medulloblastoma using a risk-stratified treatment strategy designed to defer, reduce, or delay radiation exposure...
May 16, 2018: Lancet Oncology
https://www.readbyqxmd.com/read/29777383/predictive-value-of-pct-and-il-6-for-bacterial-infection-in-children-with-cancer-and-febrile-neutropenia
#4
Hilde T van der Galiën, Erik A H Loeffen, Karin G E Miedema, Wim J E Tissing
PURPOSE: Only a third of children with cancer and febrile neutropenia (FN) have a proven bacterial infection; nevertheless, most children are hospitalized and treated with intravenous antibiotics. Several biomarkers have been proposed as predictive markers for bacterial infection in this population. We aimed to evaluate the role of interleukin-6 (IL-6) and procalcitonin (PCT) in diagnosing bacterial infection in children with cancer and FN. METHODS: The study population was derived from a prospective database (2006-2013, IL-8 study) comprising children with cancer who presented with FN...
May 19, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29774477/cefepime-vs-cefoperazone-sulbactam-in-combination-with-amikacin-as-empirical-antibiotic-therapy-in-febrile-neutropenia
#5
M Ponraj, Biswajit Dubashi, B H Harish, S Kayal, S L Cyriac, Jogamaya Pattnaik, K Ranjith, Unni S Pillai, Naresh Jadhav, Kiran K Matta, Jagdeep Singh, Esha Jaffa, Bhanu Prakash
PURPOSE: Beta lactams are standard empirical therapy for febrile neutropenia (FN). The aim of this study was to evaluate the efficacy and safety of cefepime monotherapy compared with cefoperazone/sulbactam plus amikacin (CS + A) for empirical treatment of high risk FN. METHODS: One hundred seventy-five patients with 336 FN episodes were randomized to receive either cefepime (2 g q8h for adults and 50 mg/kg q8h for children) or CS (2 g q8h for adults and 50 mg/kg q8h for children) plus amikacin (15 mg/kg once a day)...
May 17, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29768957/comparison-of-the-incidence-of-febrile-neutropenia-in-obese-and-normal-weight-breast-cancer-patients-receiving-myelosuppressive-chemotherapy-and-prophylactic-pegfilgrastim
#6
Jennifer M Collins, Gini F Fleming, Trevor N Christ
Purpose Common breast cancer chemotherapy regimens are associated with a risk of febrile neutropenia, so prophylactic colony-stimulating factors are incorporated for high-risk patients. Filgrastim utilizes weight-based dosing; however, its sustained-release formulation utilizes fixed dosing. The purpose of this study is to determine whether obese breast cancer patients who receive pegfilgrastim are at increased risk of developing febrile neutropenia. Methods This study is a single-center, retrospective chart review...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29768710/improving-the-safety-of-high-dose-methotrexate-for-children-with-hematologic-cancers-in-settings-without-access-to-mtx-levels-using-extended-hydration-and-additional-leucovorin
#7
Kalthi Vaishnavi, Deepak Bansal, Amita Trehan, Richa Jain, Savita Verma Attri
BACKGROUND: A lack of access to methotrexate levels is common in low- and middle-income countries (LMIC), relevant for 80% of children with cancer worldwide. We evaluated whether high-dose methotrexate (HD-MTX) can be administered safely with extended hydration and leucovorin rescue, with monitoring of serum creatinine and urine pH. METHODS: The prospective study was conducted at a single centre in Chandigarh, India in 2015. Patients with B-cell acute lymphoblastic leukemia (ALL) or with T-cell ALL or non-Hodgkin lymphoma (T-NHL) were administered 3 and 5 gm/m2 of MTX (24 hr infusion), respectively...
May 16, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29768470/integrative-omics-to-detect-bacteremia-in-patients-with-febrile-neutropenia
#8
Rachel S Kelly, Jessica Lasky-Su, Sai-Ching J Yeung, Richard M Stone, Jeffrey M Caterino, Sean C Hagan, Gary H Lyman, Lindsey R Baden, Brett E Glotzbecker, Christopher J Coyne, Christopher W Baugh, Daniel J Pallin
BACKGROUND: Cancer chemotherapy-associated febrile neutropenia (FN) is a common condition that is deadly when bacteremia is present. Detection of bacteremia depends on culture, which takes days, and no accurate predictive tools applicable to the initial evaluation are available. We utilized metabolomics and transcriptomics to develop multivariable predictors of bacteremia among FN patients. METHODS: We classified emergency department patients with FN and no apparent infection at presentation as bacteremic (cases) or not (controls), according to blood culture results...
2018: PloS One
https://www.readbyqxmd.com/read/29764879/quest-for-certainty-regarding-early-discharge-in-paediatric-low-risk-febrile-neutropenia-a-multicentre-qualitative-focus-group-discussion-study-involving-patients-parents-and-healthcare-professionals-in-the-uk
#9
Jessica E Morgan, Bob Phillips, Lesley A Stewart, Karl Atkin
OBJECTIVES: A systematic review of paediatric low-risk febrile neutropenia found that outpatient care is safe, with low rates of treatment failure. However, this review, and a subsequent meta-ethnography, suggested that early discharge of these patients may not be acceptable to key stakeholders. This study aimed to explore experiences and perceptions of patients, parents and healthcare professionals involved in paediatric febrile neutropenia care in the UK. SETTING: Three different centres within the UK, purposively selected from a national survey on the basis of differences in their service structure and febrile neutropenia management...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29760598/predictors-of-chemoradiation-related-febrile-neutropenia-prophylaxis-in-older-adults-experience-from-a-limited-resource-setting
#10
Aparna Gangopadhyay
Aim: To identify risk factors that lower efficacy of antibiotic prophylaxis of febrile neutropenia among older patients on chemoradiation. Background: Audit of institutional data showed that older adults are at higher risk of febrile neutropenia during chemoradiation. In limited resource settings widespread use of Granulocyte-Colony Stimulating Factor (G-CSF) is not economically feasible and antibiotics are used commonly. Despite compliance with antibiotics, prophylaxis is inadequate in many patients owing to patient and tumor related factors...
May 2018: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/29754293/chemotherapy-induced-neutropenia-as-a-prognostic-and-predictive-marker-of-outcomes-in-solid-tumor-patients
#11
REVIEW
Pashtoon Murtaza Kasi, Axel Grothey
Chemotherapy-induced neutropenia (CIN) is one of the most common side effects seen in cancer patients. As an adverse event, it is deemed undesirable since it often constitutes a dose-limiting toxicity for cytotoxic agents leading to treatment delays and/or dose reductions. It is also associated with a financial cost component from diagnostic work-up and treatment of patients with chemotherapy-induced febrile neutropenia (CIFN). Neutropenia is commonly accompanied by a decrease in other hematopoietic lineages (anemia and/or thrombocytopenia)...
May 12, 2018: Drugs
https://www.readbyqxmd.com/read/29754271/reduced-dose-epoch-r-chemotherapy-for-elderly-patients-with-advanced-stage-diffuse-large-b-cell-lymphoma
#12
Wen-Hao Zhang, Gao-Yang Li, Yu-Jie Ma, Zhi-Chao Li, Yang Zhu, Jun Chang, Si-Guo Hao, Rong Tao
The standard treatment in elderly patients with diffuse large B cell lymphoma (DLBCL) has not yet been finely established. We investigated the efficacy and safety of rituximab with a reduced-dose of EPOCH chemotherapy in elderly patients who had advanced DLBCL with high IPI scores. The dose of 70% EPOCH was given to patients aged 75 to 79 years, and dose of 50% to patients aged over 80 years. Thirty-one patients with a median age of 79 years (range 75-86 years) were enrolled. Patients received a median of 6 cycle's chemotherapy...
May 12, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29751120/evaluation-of-a-risk-guided-strategy-for-empiric-carbapenem-use-in-febrile-neutropenia
#13
Ai Leng Khoo, Ying Jiao Zhao, Monica Teng, Ding Ying, Jing Jin, Yen Lin Chee, Li Mei Poon, Siew Eng Lim, Liang Piu Koh, Wee Joo Chng, Boon Peng Lim, Li Yang Hsu, Louis Yi Ann Chai
Febrile neutropenia (FN) is associated with substantial morbidity and necessitate empiric broad spectrum antibiotic treatment. We evaluated a risk-guided FN management strategy using empiric piperacillin-tazobactam and carbapenem in a prospective cohort study. The analysis involved 723 FN episodes in hospitalised adult patients, including those with severe sepsis or prior infection/colonisation with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. Propensity score matching analysis was used to adjust for baseline differences between treatment groups and produced 267 matched pairs...
May 8, 2018: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29750396/a-phase-1-2-dose-finding-safety-and-activity-study-of-cabazitaxel-in-pediatric-patients-with-refractory-solid-tumors-including-tumors-of-the-central-nervous-system
#14
Peter E Manley, Tanya Trippett, Amy A Smith, Margaret E Macy, Sarah E S Leary, Jessica Boklan, Kenneth J Cohen, Stewart Goldman, Lindsay B Kilburn, Girish Dhall, Jeanne Devin, Cynthia E Herzog, Sonia Partap, Floris Fauchet, Emmy Badreddine, John P Bernard, Susan N Chi
BACKGROUND: This phase 1/2 study (NCT01751308) evaluated cabazitaxel in pediatric patients. Phase 1 determined the maximum tolerated dose (MTD) in patients with recurrent/refractory solid tumors, including central nervous system (CNS) tumors. Phase 2 evaluated activity in pediatric recurrent high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG). PROCEDURE: In phase 1, a 3 + 3 dose-escalation study design was followed. Cabazitaxel was administered at a starting dose of 20 mg/m2 ...
May 11, 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29749403/obinutuzumab-plus-bendamustine-in-previously-untreated-patients-with-cll-a-subgroup-analysis-of-the-green-study
#15
Stephan Stilgenbauer, Veronique Leblond, Robin Foà, Sebastian Böttcher, Osman Ilhan, Wolfgang Knauf, Eva Mikuskova, Christoph Renner, Eugen Tausch, Dariusz Woszczyk, Ekaterina Gresko, Linda Lundberg, Tom Moore, Thea Morris, Susan Robson, Francesc Bosch
GREEN (NCT01905943) is a non-randomized, open-label phase IIIb study investigating obinutuzumab alone or plus chemotherapy in chronic lymphocytic leukemia (CLL). We report a preplanned subgroup analysis of 158 previously untreated CLL patients receiving obinutuzumab-bendamustine (G-B). Patients received six 28-day cycles (C) of G-B: obinutuzumab day (D)1/D2 of C1 (25 mg D1/975 mg D2), 1000 mg D8 and D15 of C1, and D1 of C2-6; and bendamustine 70/90 mg/m2 D1 and D2 of C1-6. The primary endpoint was safety/tolerability...
April 27, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29748897/myeloid-derived-suppressor-cells-mdscs-in-patients-with-solid-tumors-considerations-for-granulocyte-colony-stimulating-factor-treatment
#16
REVIEW
Katerina Pilatova, Beatrix Bencsikova, Regina Demlova, Dalibor Valik, Lenka Zdrazilova-Dubska
Myeloid-derived suppressor cells (MDSCs) have been shown to contribute to tumor escape from host immune surveillance and to cancer progression by production of tumor-promoting soluble factors. Granulocyte colony-stimulating factor (G-CSF) is a principle cytokine controlling granulocyte number. Recombinant human G-CSF (rhG-CSF) has become the main therapeutic agent for the treatment of neutropenia and prophylaxis of febrile neutropenia in cancer patients. However, we show here that rhG-CSF triggers accumulation of granulocytic and monocytic subsets...
May 10, 2018: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/29744672/efficacy-and-safety-of-neoadjuvant-treatment-with-bevacizumab-liposomal-doxorubicin-cyclophosphamide-and-paclitaxel-combination-in-locally-regionally-advanced-her2-negative-grade-iii-at-premenopausal-status-breast-cancer-a-phase-ii-study
#17
Ekaterini C Tampaki, Athanasios Tampakis, Constantinos E Alifieris, Dimitrios Krikelis, Anastasia Pazaiti, Michalis Kontos, Dimitrios T Trafalis
BACKGROUND: In the era of personalized therapy, targeted treatment in specific patient populations is mandated. OBJECTIVE: We evaluated the efficacy and safety of neoadjuvant treatment on locally advanced breast cancer (LABC) with a monoclonal agent against vascular endothelial growth factor (VEGF), bevacizumab plus chemotherapy combination of liposomal doxorubicin, cyclophosphamide and paclitaxel (PLAC-B). METHODS: Patients enrolled were at premenopausal status and characterized by human epidermal growth factor receptor 2 (HER2)-negative, hormone-receptor positive (estrogen receptor/progesterone receptor-positive [ER/PR+]) or triple-negative (TNBC), LABC (T > 3 cm), with high-grade ductal carcinoma...
May 9, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29739790/phase-ib-ii-study-of-second-line-therapy-with-panitumumab-irinotecan-and-everolimus-pie-in-kras-wild-type-metastatic-colorectal-cancer
#18
Amanda Townsend, Niall C Tebbutt, Christos S Karapetis, Pamela Cooper, Nimit Singhal, Sue J Yeend, Louise Pirc, Rohit Joshi, Jennifer Elizabeth Hardingham, Timothy Price
PURPOSE: Inhibition of mTOR in addition to EGFR may overcome resistance to EGFR inhibitors in metastatic colorectal cancer (mCRC). This phase Ib/II study evaluated the safety and efficacy of the combination of irinotecan, panitumumab and everolimus. EXPERIMENTAL DESIGN: Patients with KRAS exon 2 WT mCRC following failure of fluoropyrimidine based therapy received IV irinotecan and panitumumab every 2 weeks, and everolimus orally throughout a 14 day cycle. The primary endpoint of the phase II study was response rate (RR)...
May 8, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29737253/febrile-neutropenia-in-children-with-cancer-approach-to-diagnosis-and-treatment
#19
Rejin Kebudi, Hande Kizilocak
Febrile neutropenia is one of the major acute side effects of intensive treatment in pediatric cancer, necessitating prompt initiation of empirical broad-spectrum antibiotics. Patients may be classified as low or high risk according some risk factors (duration of neutropenia, depth of neutropenia, type of cancer, state of disease, bone marrow involvement, type of treatment, additional health problems). Initial evaluation of the febrile neutropenic child should include the history of the child, a detailed physical examination, blood culture (peripheral and catheter), urinalysis and culture, cultures of lesions...
May 8, 2018: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29736867/development-of-a-simplified-multivariable-model-to-predict-neutropenic-complications-in-cancer-patients-undergoing-chemotherapy
#20
Abolfazl Razzaghdoust, Bahram Mofid, Maryam Moghadam
PURPOSE: Neutropenic complications remain the major dose-limiting toxicities of cancer chemotherapy. The aim of this study was to develop and internally validate a comprehensive and easily measurable scoring system for prediction of severe or febrile neutropenia in the first chemotherapy cycle of patients with solid tumors or lymphoma. METHODS: This prospective cohort study included consecutive patients at a tertiary referral hospital. Many clinical and laboratory-independent variables were measured at baseline...
May 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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