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febrile neutropenic

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https://www.readbyqxmd.com/read/29072402/outcomes-of-high-risk-patients-with-febrile-neutropenia-at-a-tertiary-care-center
#1
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/29040595/a-comparison-of-levofloxacin-and-oral-third-generation-cephalosporins-as-antibacterial-prophylaxis-in-acute-leukaemia-patients-during-chemotherapy-induced-neutropenia
#2
Kristyn E Yemm, Jason N Barreto, Kristin C Mara, Ross A Dierkhising, Naseema Gangat, Pritish K Tosh
Background: There is demonstrated benefit with fluoroquinolones as infection prophylaxis in neutropenic patients; however, side effects, drug interactions and increasing resistance necessitate investigation of alternative therapies. Objectives: To compare the incidence of febrile neutropenia in high-risk patients with haematological malignancy receiving a fluoroquinolone with those receiving an oral third-generation cephalosporin (OTGC) as antibacterial prophylaxis during chemotherapy-induced neutropenia...
October 11, 2017: Journal of Antimicrobial Chemotherapy
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
#3
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/28931099/-treatment-of-chemotherapy-induced-febrile-neutropenia-in-solid-tumors
#4
Gabriella Gálffy
One of the most dangerous complications of bone marrow suppression due to chemotherapy is febrile neutropenia. The treatment of the affected patients is a multidisciplinary task. In addition to chemotherapy, adequate G-CSF therapy as a primary and secondary prophylaxis can be used to prevent a large part of febrile neutropenic events. Before each chemotherapy cycle, the risk of febrile neutropenia should be evaluated, taking into account the chemotherapeutic combination and patient-specific parameters. Appropriate antibiotic and G-CSF therapy initiated in the course of febrile neutropenia is essential for the success of the therapy...
September 20, 2017: Magyar Onkologia
https://www.readbyqxmd.com/read/28920169/diagnostic-value-of-strem-1-il-8-pct-and-crp-in-febrile-neutropenia-after-autologous-stem-cell-transplantation
#5
C S Michel, D Teschner, E M Wagner, M Theobald, Markus P Radsak
Infections and infectious complications are the major cause of morbidity and mortality in febrile neutropenic patients after autologous stem cell transplantation. Laboratory biomarkers are helpful for early identification of critically ill patients and optimal therapy management. Several studies in adult non-neutropenic patients proposed sTREM-1 as a superior biomarker for identification of septic patients as well as a predictor for survival in these patients compared with procalcitonin (PCT), C-reactive protein (CRP), or interleukin-8 (IL-8)...
September 17, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/28845081/soluble-cd14-as-a-diagnostic-and-prognostic-biomarker-in-hematological-patients-with-febrile-neutropenia
#6
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/28826933/safety-and-efficacy-of-docetaxel-bevacizumab-and-everolimus-for-castration-resistant-prostate-cancer-crpc
#7
Mitchell E Gross, Tanya B Dorff, David I Quinn, Patricia M Diaz, Olga O Castellanos, David B Agus
BACKGROUND: Previous data suggests that co-targeting mammalian target of rapamycin and angiogenic pathways may potentiate effects of cytotoxic chemotherapy. We studied combining mammalian target of rapamycin and vascular endothelial growth factor inhibition with docetaxel in castrate-resistant prostate cancer (CRPC). METHODS: Eligible patients had progressive, metastatic, chemotherapy-naive CRPC. Docetaxel and bevacizumab were given intravenously day 1 with everolimus orally daily on a 21-day cycle across 3 dose levels (75:15:2...
July 14, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28807922/using-population-pharmacokinetic-modeling-and-monte-carlo-simulations-to-determine-whether-standard-doses-of-piperacillin-in-piperacillin-tazobactam-regimens-are-adequate-for-the-management-of-febrile-neutropenia
#8
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 suboptimal exposures. This study aimed to develop a population pharmacokinetic model for piperacillin and perform dosing simulation to describe optimal dosing regimens for hematological malignancy patients with febrile neutropenia. Concentration-time data were obtained from previous prospective observational pharmacokinetic and interventional therapeutic drug monitoring studies. Nonparametric population pharmacokinetic analysis and Monte Carlo dosing simulations were performed with the Pmetrics package for R...
November 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28776170/viridans-group-streptococci-bloodstream-infections-in-neutropenic-adult-patients-with-hematologic-malignancy-single-center-experience
#9
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/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
#10
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/28716109/clinical-characteristics-and-outcomes-of-pseudomonas-aeruginosa-bacteremia-in-febrile-neutropenic-children-and-adolescents-with-the-impact-of-antibiotic-resistance-a-retrospective-study
#11
Hyo Sup Kim, Bo Kyoung Park, Seong Koo Kim, Seung Beom Han, Jae Wook Lee, Dong-Gun Lee, Nack-Gyun Chung, Bin Cho, Dae Chul Jeong, Jin Han Kang
BACKGROUND: Although the proportion of Pseudomonas aeruginosa infections has reduced after the introduction of antibiotics with anti-pseudomonal effects, P. aeruginosa bacteremia still causes high mortality in immunocompromised patients. This study determined the clinical characteristics and outcomes of P. aeruginosa bacteremia and the antibiotic susceptibilities of strains isolated from febrile neutropenic patients. METHODS: Thirty-one febrile neutropenic children and adolescents with underlying hematologic/oncologic disorders diagnosed with P...
July 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28705670/empiric-antibiotic-protocols-for-cancer-patients-with-neutropenia-a-single-center-study-of-treatment-efficacy-and-mortality-in-patients-with-bacteremia
#12
Eyal Kleinhendler, Matan J Cohen, Allon E Moses, Ora Paltiel, Jacob Strahilevitz, Amos Cahan
BACKGROUND: A number of empiric antibiotic treatment options for febrile neutropenia exist, yet there is no universally-accepted initial protocol. We aimed to assess the performance of a protocol (piperacillin, gentamicin and cefazolin) introduced over 40 years ago and compare its coverage against bacteria isolated from blood of neutropenic patients to that of various commonly used antibiotic treatment protocols. METHODS: Adults with neutropenia admitted between 2003 and 2012 to the hemato-oncologic departments, in whom blood cultures were taken on admission were included...
July 10, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28660351/moxifloxacin-versus-levofloxacin-or-ciprofloxacin-prophylaxis-in-acute-myeloid-leukemia-patients-receiving-chemotherapy
#13
Daniel J Przybylski, David J Reeves
PURPOSE: Patients receiving intensive chemotherapy regimens are at high risk for infectious complications due to prolonged neutropenia and hospital stay. Fluoroquinolone antibiotics, mainly levofloxacin and ciprofloxacin, are the mainstay of prophylactic therapy for these patients. There is limited data regarding the utilization of other quinolone antibiotics including moxifloxacin in this setting. METHODS: A retrospective chart review was completed comparing the use of prophylactic moxifloxacin to that of levofloxacin or ciprofloxacin during periods of prolonged neutropenia...
December 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28636889/complications-of-hematopoietic-stem-transplantation-fungal-infections
#14
REVIEW
Ali S Omrani, Reem S Almaghrabi
Patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) are at increased risk of invasive fungal infections, especially during the early neutropenic phase and severe graft-versus-host disease. Mold-active prophylaxis should be limited to the highest risk groups. Empiric antifungal therapy for HSCT with persistent febrile neutropenia is associated with unacceptable response rates, unnecessary antifungal therapy, increased risk of toxicity, and inflated costs. Empiric therapy should not be a substitute for detailed work up to identify the cause of fever in such patients...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28626736/enterococcus-spp-and-s-aureus-colonization-in-neutropenic-febrile-children-with-cancer
#15
Julia R Spinardi, Rodrigo Berea, Patricia A Orioli, Marina M Gabriele, Alessandra Navarini, Marina T Marques, Milton N Neto, Marcelo J Mimica
INTRODUCTION: Febrile neutropenia is one of the most serious treatment-related complications in cancer patients. Susceptible to rapidly progressing infections, which result in prolonged hospitalization and use of broad-spectrum antibiotics, neutropenic patients are subject to colonization by multiresistant agents, which enhances the risk of infections. METHODS: In this study we included samples collected with nasal, oropharyngeal and anal swabs from hospitalized children with febrile neutropenia following chemotherapy, between March 2014 and 2015, aiming to elucidate colonization by S...
June 2017: Germs
https://www.readbyqxmd.com/read/28601903/can-complications-in-febrile-neutropenia-be-predicted-report-from-a-developing-country
#16
Sapna Oberoi, Anirban Das, Amita Trehan, Pallab Ray, Deepak Bansal
PURPOSE: Febrile neutropenia (FN) is an important cause of morbidity and mortality in children with acute lymphoblastic leukemia (ALL). We aimed to look at complications in febrile neutropenia and to derive a risk model for developing complications from the variables predicting complications. METHODS: Children on treatment for ALL, presenting with FN, were prospectively enrolled over a period of 1 year. Their clinical presentation, course during hospital stay, and outcomes were recorded...
November 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28597476/safe-fluoroquinolones-prophylaxis-in-blood-cancer-patients-with-chemotherapy-induced-neutropenia-and-glucose-6-phosphate-dehydrogenase-deficiency
#17
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
#18
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/28584756/disseminated-cutaneous-trichosporonosis-in-an-adult-bone-marrow-transplant-patient
#19
A M Y Yong, S S Yang, K B Tan, S A Ho
The Trichosporon species are yeast-like opportunistic pathogens in immunocompromised patients. Trichosporon asahii infections have been reported in pediatric bone marrow transplant (BMT) patients. However, its incidence is low in the adult literature. A 52-year-old Chinese woman who was diagnosed with acute myeloid leukemia received induction chemotherapy and underwent allogenic bone marrow transplant, which was complicated by a relapse and required salvage chemotherapy. She developed persistent non-neutropenic fever secondary to presumed hepatosplenic candidiasis...
May 2017: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/28577308/empirical-antibiotics-targeting-gram-positive-bacteria-for-the-treatment-of-febrile-neutropenic-patients-with-cancer
#20
REVIEW
Ofrat Beyar-Katz, Yaakov Dickstein, Sara Borok, Liat Vidal, Leonard Leibovici, Mical Paul
BACKGROUND: The pattern of infections among neutropenic patients with cancer has shifted in the last decades to a predominance of gram-positive infections. Some of these gram-positive bacteria are increasingly resistant to beta-lactams and necessitate specific antibiotic treatment. OBJECTIVES: To assess the effectiveness of empirical anti-gram-positive (antiGP) antibiotic treatment for febrile neutropenic patients with cancer in terms of mortality and treatment failure...
June 3, 2017: Cochrane Database of Systematic Reviews
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