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Neutropenic sepsis

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https://www.readbyqxmd.com/read/29153062/-diagnostic-accuracy-of-the-lightcycler%C3%A2-septifast-assay-in-the-childhood-febrile-neutropenia
#1
Esra Mimaroğlu, Elvan Çağlar Çıtak, Necdet Kuyucu, Gönül Arslan
Infection is the main problem among the patients receiving cancer therapy. The mortality rate can be reduced by the appropriate treatment in the right time. Although blood culture is the gold standard for the diagnoses of sepsis, many factors influence the results of blood culture in children. For this reason, real time polymerase chain reaction (Rt-PCR) has gained importance for the diagnoses of microbiological agents as it is faster than the conventional methods. In this study, we aimed to compare the efficacy of SeptiFast (SF) test with blood culture among children with neutropenic fever...
October 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/29125257/improving-door-to-needle-times-for-patients-with-suspected-neutropenic-sepsis
#2
Tracy Wild
Neutropenic sepsis is a potentially life-threatening complication of chemotherapy and has an associated mortality of 2% to 21%. Patients can deteriorate rapidly and are usually advised to attend their local emergency department (ED) for urgent assessment and antibiotic therapy within one hour of arrival. Delivery of this emergency care is, however, inconsistent, and at times suboptimal, due to a lack of awareness of the condition and of clinical expertise. This article discusses a collaborative project between an acute oncology service and an ED, which has improved and sustained compliance with this standard through a range of initiatives, including revised and integrated sepsis guidelines, education, sepsis champions and a fast-track patient pathway...
November 10, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29110837/the-burden-of-neutropenic-sepsis-in-patients-with-advanced-non-small-cell-lung-cancer-treated-with-single-agent-docetaxel-a-retrospective-study
#3
Toby Talbot, Adam Dangoor, Riyaz Shah, Jay Naik, Denis Talbot, Jason F Lester, Riccardo Cipelli, Matt Hodgson, Ajay Patel, Max Summerhayes, Thomas Newsom-Davis
OBJECTIVES: To describe rates of confirmed and suspected neutropenic sepsis (NS) and associated hospital resource utilisation in patients with non-small cell lung cancer (NSCLC) treated with docetaxel monotherapy following relapse after ≥1 line of chemotherapy in routine UK clinical practice. MATERIALS AND METHODS: A multi-centre, retrospective, observational research study was conducted in seven centres across England and Wales. Adult patients with stage III/IV NSCLC initiated on docetaxel monotherapy between 2010 and 2016 in routine clinical practice (aged ≥18 years at initiation) following failure of first-line chemotherapy were eligible...
November 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/29078933/neutropenic-fever
#4
REVIEW
Lindsey White, Michael Ybarra
Fever is a common presenting complaint among adult or pediatric patients in the emergency department setting. Although fever in healthy individuals does not necessarily indicate severe illness, fever in patients with neutropenia may herald a life-threatening infection. Therefore, prompt recognition of patients with neutropenic fever is imperative. Serious bacterial illness is a significant cause of morbidity and mortality for neutropenic patients. Neutropenic fever should trigger the initiation of a rapid work-up and the administration of empiric systemic antibiotic therapy to attenuate or avoid the progression along the spectrum of sepsis, severe sepsis, septic shock syndrome, and death...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/29072402/outcomes-of-high-risk-patients-with-febrile-neutropenia-at-a-tertiary-care-center
#5
Asif Husain Osmani, Adnan Abdul Jabbar, Manesh Kumar Gangwani, Bilal Hassan
Fever during chemotherapy-induced neutropenia continues to be a major cause of morbidity and mortality in cancer patients. Mortality depends on the duration and degree of neutropenia, bacteremia, sepsis, performance status, comorbidities and other parameters. The highest mortality rates in cancer patients hospitalized with febrile neutropenia (FN) are observed in those with documented infection. The objectives of the study were to present available tools for risk assessment, to review pathogens causing infections in adult FN patients and to assess outcomes...
October 26, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/29037891/chemotherapy-based-stem-cell-mobilization-does-not-result-in-significant-paraprotein-reduction-in-myeloma-patients-in-the-era-of-novel-induction-regimens
#6
Anthony Oyekunle, Evgenii Shumilov, Philippe Kostrewa, Andreas Burchert, Lorenz Trümper, Patrick Wuchter, Gerald Wulf, Ulrike Bacher, Nicolaus Kröger
Novel induction agents markedly improved remission rates in multiple myeloma (MM), and the continued use of chemotherapy for CD34(+) stem cell mobilization (SCM) has been questioned. We examined the additional effect of chemotherapy in SCM regarding remission status/morbidity. We reviewed 236 consecutive MM patients (aged 36 to 75 years) with first autologous stem cell transplantation from January 2009 to March 2016 after chemotherapy-based SCM. Responses were measured by changes in intact Ig and free light chain levels before and after chemomobilization (International Myeloma Working Group [IMWG] criteria)...
October 13, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28993098/acute-oncology-care-a-narrative-review-of-the-acute-management-of-neutropenic-sepsis-and-immune-related-toxicities-of-checkpoint-inhibitors
#7
Thomas Knight, Shin Ahn, Terry W Rice, Tim Cooksley
Cancer care has become increasingly specialized and advances in therapy have resulted in a larger number of patients receiving care. There has been a significant increase in the number of patients presenting with cancer related emergencies including treatment toxicities and those directly related to the malignancy. Suspected neutropenic sepsis is an acute medical emergency and empirical antibiotic therapy should be administered immediately. The goal of empirical therapy is to cover the most likely pathogens that will cause life-threatening infections in neutropenic patients...
October 6, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28916371/ramucirumab-plus-docetaxel-versus-placebo-plus-docetaxel-in-patients-with-locally-advanced-or-metastatic-urothelial-carcinoma-after-platinum-based-therapy-range-a-randomised-double-blind-phase-3-trial
#8
Daniel P Petrylak, Ronald de Wit, Kim N Chi, Alexandra Drakaki, Cora N Sternberg, Hiroyuki Nishiyama, Daniel Castellano, Syed Hussain, Aude Fléchon, Aristotelis Bamias, Evan Y Yu, Michiel S van der Heijden, Nobuaki Matsubara, Boris Alekseev, Andrea Necchi, Lajos Géczi, Yen-Chuan Ou, Hasan Senol Coskun, Wen-Pin Su, Miriam Hegemann, Ivor J Percent, Jae-Lyun Lee, Marcello Tucci, Andrey Semenov, Fredrik Laestadius, Avivit Peer, Giampaolo Tortora, Sufia Safina, Xavier Garcia Del Muro, Alejo Rodriguez-Vida, Irfan Cicin, Hakan Harputluoglu, Ryan C Widau, Astra M Liepa, Richard A Walgren, Oday Hamid, Annamaria H Zimmermann, Katherine M Bell-McGuinn, Thomas Powles
BACKGROUND: Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population. METHODS: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy...
September 12, 2017: Lancet
https://www.readbyqxmd.com/read/28884286/combination-of-irinotecan-oxaliplatin-and-5-fluorouracil-as-a-rechallenge-regimen-for-heavily-pretreated-metastatic-colorectal-cancer-patients
#9
Gustavo Dos Santos Fernandes, Maria Ignez Braghiroli, Michelle Artioli, Ana Carolina Carvalho Rocha Paterlini, Marcela Crosara Teixeira, Brenda Pires Gumz, Daniel da Motta Girardi, Oddone F M Braghiroli, Frederico Perego Costa, Paulo M Hoff
PURPOSE: Our objective was to evaluate the benefit of re-exposing patients with refractory metastatic colorectal cancer (mCRC) to a combination of oxaliplatin, irinotecan and 5-fluorouracil treatment. METHODS: We retrospectively analysed patients with mCRC who received a combination of oxaliplatin, irinotecan and fluorouracil as a rechallenge regimen after progressing on the same drugs. Both FOLFOXIRI and FOLFIRINOX were used. Toxicity was evaluated for each treatment cycle, and survival analysis was performed using the Kaplan-Meier method...
September 8, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28845081/soluble-cd14-as-a-diagnostic-and-prognostic-biomarker-in-hematological-patients-with-febrile-neutropenia
#10
Sini Korpelainen, Carina Intke, Sari Hämäläinen, Esa Jantunen, Auni Juutilainen, Kari Pulkki
OBJECTIVE: Elevated levels of a cell surface glycoprotein, soluble cluster of differentiation 14 (sCD14), have been observed in patients with sepsis. Only scarce data are available on sCD14 in hematological patients with chemotherapy-induced febrile neutropenia. The study aim was to investigate sCD14 as an early biomarker in febrile neutropenia after intensive chemotherapy to detect a rapidly deteriorating clinical course early enough to avoid serious infectious complications. PATIENTS AND METHODS: This prospective study included 87 adult hematological patients at the start of febrile neutropenia after intensive chemotherapy for acute myeloid leukemia or after autologous stem cell transplantation...
2017: Disease Markers
https://www.readbyqxmd.com/read/28774898/fda-approval-summary-trabectedin-for-unresectable-or-metastatic-liposarcoma-or-leiomyosarcoma-following-an-anthracycline-containing-regimen
#11
Amy Barone, Dow-Chung Chi, Marc R Theoret, Huanyu Chen, Kun He, Dubravka Kufrin, Whitney S Helms, Sriram Subramaniam, Hong Zhao, Anuja Patel, Kirsten B Goldberg, Patricia Keegan, Richard Pazdur
On October 23, 2015, the FDA approved trabectedin, a new molecular entity for the treatment of patients with unresectable or metastatic liposarcoma or leiomyosarcoma who received a prior anthracycline-containing regimen. Approval was based on results of a single, randomized, active-controlled, 518-patient, multicenter study comparing the safety and efficacy of trabectedin 1.5 mg/m(2) as a 24-hour continuous intravenous (i.v.) infusion once every 3 weeks with dacarbazine 1,000 mg/m(2) i.v. once every 3 weeks...
August 3, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28769538/cytokine-kinetics-in-febrile-neutropenic-children-insights-on-the-usefulness-as-sepsis-biomarkers-influence-of-filgrastim-and-behavior-of-the-il-23-il-17-pathway
#12
Orlei Ribeiro de Araujo, Reinaldo Salomão, Milena Karina Coló Brunialti, Dafne Cardoso Bourguignon da Silva, Andreza Almeida Senerchia, Fabianne Altruda de Moraes Costa Carlesse, Antonio Sergio Petrilli
BACKGROUND: The study aimed to describe the kinetics of various cytokines from day 1 to day 14 of the onset of fever in neutropenic children and to evaluate their performances as discriminators of sepsis in the first 24 hours of fever, the possible influence of filgrastim, and the functioning of the IL-23/IL-17 axis. METHODS: IL-1β, TNF-α, IL-10, IL-12/23p40, IL-21, IL-6, IL-8, IL-17, G-CSF, and GM-CSF were measured in plasma on days 1, 2, 3, 5, and 14 from the onset of fever in 35 patients...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28745171/neutropenic-sepsis
#13
Bing Raz
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? The article discussed the prevention, identification and treatment of neutropenic sepsis, which is a potentially life-threatening complication of chemotherapy.
July 26, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28688700/a-phase-i-study-of-cabazitaxel-in-combination-with-platinum-and-5-fluorouracil-pf-in-locally-advanced-squamous-cell-carcinoma-of-head-and-neck-la-scchn
#14
Nadia Camille, John Rozehnal, Elizabeth Roy, Dariusz Uczkowski, Ashely Olson, Eric Genden, Marita Teng, Richard Bakst, Vishal Gupta, Marshall Posner, Krzysztof Misiukiewicz
BACKGROUND: There is a clinical need to improve outcomes for patients with locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN), especially in Human Papilloma Virus (HPV) negative and HPV positive subtypes with a significant history of tobacco use. In animal models bearing SCCHN, Cabazitaxel showed an excellent response rate compared to docetaxel and might prove useful in treatment of patients. The primary objective of this study was to determine the dose-limiting toxicity (DLT) and maximum tolerated dose (MTD) of cabazitaxel when combined with cisplatin and 5-fluorouracil (PF) in induction chemotherapy (IC) for patients with SCCHN...
August 2017: Oral Oncology
https://www.readbyqxmd.com/read/28597476/safe-fluoroquinolones-prophylaxis-in-blood-cancer-patients-with-chemotherapy-induced-neutropenia-and-glucose-6-phosphate-dehydrogenase-deficiency
#15
M Sanna, G Caocci, F Orrù, A Ledda, A Vacca, E Piras, C Fozza, P Deias, G Tidore, F Dore, G La Nasa
WHAT IS KNOWN AND OBJECTIVE: Bacterial infections are the leading causes of morbidity and mortality in haematologic patients with chemotherapy-induced neutropenia. The only strategy shown to be effective in reducing febrile neutropenia incidence is fluoroquinolone prophylaxis, but the safety of this class of drugs in patients with glucose-6-phosphate dehydrogenase deficiency (G6PD-), the most common human enzyme defect, is still controversial because of the claimed association with acute haemolytic anaemia...
June 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28596652/changing-trends-in-the-use-of-granulocyte-transfusions-in-neutropenic-children-with-sepsis-in-india
#16
Ramya Uppuluri, Sreejith Ramachandrakurup, Lakshman Vaidhyanathan, Sathishkumar Kandath, Divya Subburaj, Revathi Raj
We present our data on granulocyte transfusions in children undergoing treatment for cancer and HSCT at our centre and their changing indications. In this retrospective observational analysis of children who received granulocytes from 2007 to 2015, we divided children receiving granulocytes into two groups-the first from January 2007 till December 2013 and the second from January 2014 till December 2015. This division is based on the change in our policy to use granulocytes within 48 h of septicemia as the incidence of drug resistant bacterial strains had increased at our centre...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28526536/trastuzumab-emtansine-versus-capecitabine-plus-lapatinib-in-patients-with-previously-treated-her2-positive-advanced-breast-cancer-emilia-a-descriptive-analysis-of-final-overall-survival-results-from-a-randomised-open-label-phase-3-trial
#17
RANDOMIZED CONTROLLED TRIAL
Véronique Diéras, David Miles, Sunil Verma, Mark Pegram, Manfred Welslau, José Baselga, Ian E Krop, Kim Blackwell, Silke Hoersch, Jin Xu, Marjorie Green, Luca Gianni
BACKGROUND: The antibody-drug conjugate trastuzumab emtansine is indicated for the treatment of patients with HER2-positive metastatic breast cancer previously treated with trastuzumab and a taxane. Approval of this drug was based on progression-free survival and interim overall survival data from the phase 3 EMILIA study. In this report, we present a descriptive analysis of the final overall survival data from that trial. METHODS: EMILIA was a randomised, international, open-label, phase 3 study of men and women aged 18 years or older with HER2-positive unresectable, locally advanced or metastatic breast cancer previously treated with trastuzumab and a taxane...
June 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28473406/phase-1-multicenter-trial-of-brentuximab-vedotin-for-steroid-refractory-acute-graft-versus-host-disease
#18
MULTICENTER STUDY
Yi-Bin Chen, Miguel-Angel Perales, Shuli Li, Maria Kempner, Carol Reynolds, Jami Brown, Yvonne A Efebera, Steven M Devine, Areej El-Jawahri, Steven L McAfee, Thomas R Spitzer, Robert J Soiffer, Jerome Ritz, Corey Cutler
Therapy for steroid-refractory acute graft-versus-host disease (SR-aGVHD) remains suboptimal. Preclinical data demonstrate increased CD30 expression on activated CD8(+) T cells during aGVHD. Brentuximab vedotin (BV) is an antibody-drug conjugate targeting CD30. We conducted a multicenter phase 1 trial in 34 patients to establish the maximum tolerated dose (MTD) of BV for SR-aGVHD treatment. A 3+3 cohort design was conducted initially with BV given weekly × 3 doses followed by maintenance dosing (initial dose 0...
June 15, 2017: Blood
https://www.readbyqxmd.com/read/28469892/chasing-the-golden-hour-lessons-learned-from-improving-initial-neutropenic-sepsis-management
#19
Caroline Forde, Paula Scullin
Neutropenic sepsis remains a time critical and potentially fatal complication of systemic anti-cancer therapy. A target 'door to needle' time of one hour for first dose empirical intravenous antibiotics continues to be promoted nationally. A baseline audit (June 2011) highlighted shortfalls in care in the Belfast Trust, with only 15% of patients receiving antibiotics within sixty minutes. A multi-professional group within the Trust was established to try and initiate the improvements in neutropenic sepsis recognition and initial management that were urgently required...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28404756/infusion-compatible-antibiotic-formulations-for-rapid-administration-to-improve-outcomes-in-cancer-outpatients-with-severe-sepsis-and-septic-shock-the-sepsis-stat-pack
#20
Jason D Goldman, Amelia Gallaher, Rupali Jain, Zach Stednick, Manoj Menon, Michael J Boeckh, Paul S Pottinger, Stephen M Schwartz, Corey Casper
Background: Patients with cancer are at high risk for severe sepsis and septic shock (SS/SSh), and a delay in receiving effective antibiotics is strongly associated with mortality. Delays are due to logistics of clinic flow and drug delivery. In an era of increasing antimicrobial resistance, combination therapy may be superior to monotherapy for patients with SS/SSh. Patients and Methods: At the Seattle Cancer Care Alliance, we implemented the Sepsis STAT Pack (SSP) program to simplify timely and effective provision of empiric antibiotics and other resuscitative care to outpatients with cancer with suspected SS/SSh before hospitalization...
April 2017: Journal of the National Comprehensive Cancer Network: JNCCN
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