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neutropenic fever

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https://www.readbyqxmd.com/read/29227565/limited-utility-of-routine-chest-x-ray-in-initial-evaluation-of-neutropenic-fever-in-patients-with-haematological-diseases-undergoing-chemotherapy
#1
Ortis Estacio, Zoe Loh, Amy Baker, Geoff Chong, Andrew Grigg, Leonid Churilov, Eliza A Hawkes
BACKGROUND: Routine chest X-Ray (CXR) is recommended for neutropenic fever(NF) management however its role is relatively understudied in haematology patients. METHODS: Retrospective, single-centre analysis of haematology patients admitted with NF between January 2011-December 2015. Baseline demographics, treatment details and outcomes were collected from electronic patient records. CXRs underwent independent radiology review. Primary endpoints were proportion of NF episodes in which CXR detected a probable chest infection in the absence of respiratory symptoms/signs, and/or resulted in a change in antibiotic management...
December 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29218692/euro-b-o-s-s-a-european-study-on-chemotherapy-in-bone-sarcoma-patients-aged-over-40-outcome-in-primary-high-grade-osteosarcoma
#2
Stefano Ferrari, Stefan S Bielack, Sigbjørn Smeland, Alessandra Longhi, Gerlinde Egerer, Kirsten Sundby Hall, Davide Donati, Matthias Kevric, Otte Brosjö, Alessandro Comandone, Mathias Werner, Odd Monge, Emanuela Palmerini, Wolfgang E Berdel, Bodil Bjerkehagen, Anna Paioli, Sylvie Lorenzen, Mikael Eriksson, Marco Gambarotti, Per-Ulf Tunn, Nina L Jebsen, Marilena Cesari, Thekla von Kalle, Virginia Ferraresi, Rudolf Schwarz, Rossella Bertulli, Anne-Katrin Kasparek, Giovanni Grignani, Fatime Krasniqi, Benjamin Sorg, Stefanie Hecker-Nolting, Piero Picci, Peter Reichardt
INTRODUCTION: The EUROpean Bone Over 40 Sarcoma Study (EURO-B.O.S.S.) was the first prospective international study for patients 41-65 years old with high-grade bone sarcoma treated with an intensive chemotherapy regimen derived from protocols for younger patients with high-grade skeletal osteosarcoma. METHODS: Chemotherapy based on doxorubicin, cisplatin, ifosfamide, and methotrexate was suggested, but patients treated with other regimens at the investigators' choice were also eligible for the study...
December 5, 2017: Tumori
https://www.readbyqxmd.com/read/29200325/incidence-and-risk-factors-of-bacterial-and-fungal-infection-during-induction-chemotherapy-for-high-risk-neuroblastoma
#3
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
December 4, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29178248/no-indication-of-increased-infection-rates-using-low-dose-alemtuzumab-instead-of-anti-thymocyte-globulin-as-graft-versus-host-disease-prophylaxis-before-allogeneic-stem-cell-transplantation
#4
Thomas Neumann, Laila Schneidewind, Thomas Thiele, Daniel Pink, Meike Schulze, Christian Schmidt, William Krüger
BACKGROUND: Alemtuzumab as part of the conditioning protocol is effective in reducing graft-versus-host disease (GvHD), but may be associated with increased infection rates, especially when using high doses (ie, 100 mg). METHODS: We performed a retrospective, single-centre, case-control study analysing the rates of neutropenic fever, cytomegalovirus (CMV) reactivation, Epstein-Barr virus (EBV) reactivation, clinical manifest toxoplasmosis, and clinical manifest human herpesvirus-6 (HHV6) infection using low-dose alemtuzumab in comparison with anti-thymocyte globulin (ATG) as GvHD prophylaxis before allogeneic stem cell transplantation...
November 27, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29171916/distribution-and-clinical-determinants-of-time-to-positivity-of-blood-cultures-in-patients-with-neutropenia
#5
M M C Lambregts, E B Warreman, A T Bernards, J H Veelken, P A von dem Borne, O M Dekkers, L G Visser, M G J de Boer
OBJECTIVES: Blood cultures (BC) are essential in the evaluation of neutropenic fever. Modern BC systems have significantly reduced the time-to-positivity (TTP) of BC. This study explores the probability of bacteraemia when BC have remained negative for different periods of time. METHODS: All adult patients with neutropenia and bacteraemia were included (January 2012-February 2016). Predictive clinical factors for short (≤16 hours) and long (>24 hours) TTP were determined...
November 24, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29168032/comparison-of-the-mascc-and-cisne-scores-for-identifying-low-risk-neutropenic-fever-patients-analysis-of-data-from-three-emergency-departments-of-cancer-centers-in-three-continents
#6
Shin Ahn, Terry W Rice, Sai-Ching J Yeung, Tim Cooksley
PURPOSE: Patients with febrile neutropenia are a heterogeneous group with a minority developing serious medical complications. Outpatient management of low-risk febrile neutropenia has been shown to be safe and cost-effective. Scoring systems, such as the Multinational Association for Supportive Care in Cancer (MASCC) score and Clinical Index of Stable Febrile Neutropenia (CISNE), have been developed and validated to identify low-risk patients. We aimed to compare the performance of these two scores in identifying low-risk febrile neutropenic patients...
November 22, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29153062/-diagnostic-accuracy-of-the-lightcycler%C3%A2-septifast-assay-in-the-childhood-febrile-neutropenia
#7
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/29134688/neutropenic-fever-during-peripheral-blood-progenitor-cell-mobilization-is-associated-with-decreased-cd34-cell-collection-and-increased-apheresis-collection-days
#8
Jack Khouri, Lisa Rybicki, Navneet Majhail, Matt Kalaycio, Edward Copelan, Brad Pohlman, Brian Hill, Robert Dean, Aleksandr Lazaryan, Betty Hamilton, Steven Andresen, Ronald Sobecks, Brian Bolwell, Hien Liu
BACKGROUND: Peripheral blood progenitor cell (PBPC) mobilization with chemotherapy in addition to Granulocyte-Colony Stimulating Factor (G-CSF) improves cell collection compared to G-CSF alone; however, it is associated with increased risk of neutropenic fever (NF). METHODS: We analyzed risk factors for post-priming NF and NF association with autologous stem cell transplant outcomes. Between 1998 and 2008, 593 adult patients with lymphoma underwent PBPC mobilization with etoposide and G-CSF...
November 14, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29100977/evaluation-of-weekly-paclitaxel-plus-carboplatin-followed-by-anthracycline-chemotherapy-on-the-neoadjuvant-treatment-of-patients-with-triple-negative-breast-cancer
#9
Aurelio B Castrellon
OBJECTIVE: To evaluate the effectiveness and tolerability of neoadjuvant chemotherapy with weekly paclitaxel in combination with weekly carboplatin area under curve 2 followed by anthracycline chemotherapy. PATIENTS AND METHODS: This is a retrospective review of electronic medical records of patients (N = 32) with stage 1c-III triple-negative breast cancer. Patients received neoadjuvant chemotherapy with paclitaxel 80 mg/m(2) once per week for 12 weeks in combination with carboplatin area under curve 2 once per week for 12 weeks (wP + wCb), followed by a standard anthracycline regimen including either doxorubicin 60 mg/m(2) and cyclophosphamide 600 mg/m(2) every 2 or 3 weeks, or epirubicin 90 mg/m(2) and cyclophosphamide 600 mg/m(2) every 3 weeks for four cycles with myeloid growth factor support...
October 28, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/29078933/neutropenic-fever
#10
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/29075543/undetected-severe-fetal-myelosuppression-following-administration-of-high-dose-cytarabine-for-acute-myeloid-leukemia-is-more-frequent-surveillance-necessary
#11
Jessica Parrott, Marium Holland
BACKGROUND: Cytarabine use during pregnancy carries a 5-7% risk of neonatal cytopenia. We report two cases of fetal myelosuppression following high-dose cytarabine administration for acute myeloid leukemia (AML). CASE 1: A 36-year-old G9P6 diagnosed with AML at 21 weeks was monitored for fetal anemia weekly and growth monthly. At 33 weeks (after 2 cycles), BPP was 2/10 and MCA PSV was elevated at 1.51 MoM. Urgent cesarean section was performed. The infant had an initial pH of 6...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29072402/outcomes-of-high-risk-patients-with-febrile-neutropenia-at-a-tertiary-care-center
#12
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/29050538/evaluation-of-the-head-and-neck-cancer-patient-population-and-the-incidence-of-hospitalization-at-an-academic-medical-center
#13
Lindsay A Hazelden, Matthew J Newman, Stephanie Shuey, Julie M Waldfogel, Victoria T Brown
Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29043231/voriconazole-plus-caspofungin-for-treatment-of-invasive-fungal-infection-in-children-with-acute-leukemia
#14
Kyu Ho Lee, Young Tae Lim, Jeong Ok Hah, Yu Kyung Kim, Chae Hoon Lee, Jae Min Lee
BACKGROUND: Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs. METHODS: In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013...
September 2017: Blood Research
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
#15
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/29035192/bacillus-cereus-bacteremia-with-central-nervous-system-involvement-a-neuropathological-study
#16
Jean Philippe Brouland, Nathalie Sala, Selin Tusgul, Caterina Rebecchini, Enikö Kovari
Bacillus cereus is a widely-distributed, gram-positive or variable, rod-shaped bacterium frequently considered a contaminant in clinical specimens. It is recognized as a potential pathogen inducing self-limiting emetic or diarrheal food poisoning or localized infection in immunocompetent patients. True B. cereus bacteremia is uncommon and mainly observed in fragile patients, notably in immunocompromised individuals. We report clinical, radiological, and pathological findings of a 64-year-old patient with a history of acute myeloid leukemia who initially presented a fever while neutropenic after the induction of a second cycle of chemotherapy...
October 16, 2017: Clinical Neuropathology
https://www.readbyqxmd.com/read/29031170/a-dose-escalation-study-of-bi-daily-once-weekly-oral-docetaxel-either-as-modradoc001-or-modradoc006-combined-with-ritonavir
#17
Vincent A de Weger, Frederik E Stuurman, Jeroen J M A Hendrikx, Johannes J Moes, Emilia Sawicki, Alwin D R Huitema, Bastiaan Nuijen, Bas Thijssen, Hilde Rosing, Marianne Keessen, Marja Mergui-Roelvink, Jos H Beijnen, Jan H M Schellens, Serena Marchetti
INTRODUCTION: Two solid dispersions of docetaxel (denoted ModraDoc001 capsule and ModraDoc006 tablet (both 10 mg)) were co-administered with 100 mg ritonavir (/r) and investigated in a bi-daily once weekly (BIDW) schedule. Safety, maximum tolerated dose (MTD), pharmacokinetics (PK) and preliminary activity were explored. METHODS: Adult patients with metastatic solid tumours were included in two dose-escalation arms. PK sampling was performed during the first week and the second or third week...
October 11, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29018966/safety-and-cost-benefit-of-an-ambulatory-program-for-patients-with-low-risk-neutropenic-fever-at-an-australian-centre
#18
Benjamin W Teh, Christine Brown, Trish Joyce, Leon J Worth, Monica A Slavin, Karin A Thursky
BACKGROUND: Neutropenic fever (NF) is a common complication of cancer chemotherapy. Patients at low risk of medical complications from NF can be identified using a validated risk assessment and managed in an outpatient setting. This is a new model of care for Australia. This study described the implementation of a sustainable ambulatory program for NF at a tertiary cancer centre over a 12-month period. METHODS: Peter MacCallum Cancer Centre introduced an ambulatory care program in 2014, which identified low-risk NF patients, promoted early de-escalation to oral antibiotics, and early discharge to a nurse-led ambulatory program...
October 10, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28961834/a-phase-ii-study-of-temsirolimus-added-to-low-dose-weekly-carboplatin-and-paclitaxel-for-patients-with-recurrent-and-or-metastatic-r-m-head-and-neck-squamous-cell-carcinoma-hnscc
#19
L A Dunn, M G Fury, H Xiao, S S Baxi, E J Sherman, S Korte, C Pfister, S Haque, N Katabi, A L Ho, D G Pfister
Background: Activating events along the PI3K/mTOR pathway are common in head and neck squamous cell carcinomas (HNSCC), and preclinical studies suggest additive or synergistic effects when combining mTORC1 inhibitors with carboplatin and paclitaxel chemotherapy. Patients and methods: In this single-institution phase II study, the combination of temsirolimus 25 mg, carboplatin AUC 1.5, and paclitaxel 80 mg/m2 administered on days 1 and 8 of a 21-day cycle was evaluated in 36 patients with recurrent and/or metastatic (R/M) HNSCC...
October 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28922285/what-where-and-why-exploring-fluorodeoxyglucose-pet-s-ability-to-localise-and-differentiate-infection-from-cancer
#20
Abby Douglas, Eddie Lau, Karin Thursky, Monica Slavin
PURPOSE OF REVIEW: To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer. RECENT FINDINGS: FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising...
December 2017: Current Opinion in Infectious Diseases
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