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https://www.readbyqxmd.com/read/28636889/complications-of-hematopoietic-stem-transplantation-fungal-infections
#1
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/28634525/pseudomembranous-aspergillar-tracheobronchitis-in-a-non-neutropenic-critically-ill-patient-in-the-intensive-care-unit
#2
Sameen Khalid, Fnu Asad-Ur -Rahman, Aamer Abbass, Sigfredo Aldarondo, Khalid Abusaada
Invasive aspergillosis is an important cause of morbidity and mortality among immunocompromised patients. Prolonged neutropenia is the most common risk factor. It has rarely been reported to occur in non-neutropenic critically ill patients in the intensive care unit setting. Mortality rate in this group has been reported to be as high as 92%. We report a case of tracheobronchial aspergillosis in a non-neutropenic critically ill patient to highlight the fact that critically ill patients admitted in the intensive care unit can develop opportunistic infections such as invasive aspergillosis even in the absence of classic risk factors and prior history of immunosuppression...
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28630185/in-vivo-biomarker-analysis-of-intranasally-dosed-pc945-a-novel-antifungal-triazole-on-aspergillus-fumigatus-infection-in-immunocompromised-mice
#3
Genki Kimura, Takahiro Nakaoki, Thomas Colley, Garth Rapeport, Pete Strong, Kazuhiro Ito, Yasuo Kizawa
PC945 is a novel triazole optimised for lung delivery and the objective of this study is to determine the effects of intranasally dosed PC945 on Aspergillus fumigatus infection and associated biomarkers in immunocompromised mice. PC945, posaconazole or voriconazole was treated intranasally once daily on days 0 to 3 (early intervention) or days 1 to 3 (late intervention) post-infection in temporarily neutropenic A/J mice infected intranasally with A. fumigatus, and bronchoalveolar lavage fluid (BALF) and serum were collected on day 3...
June 19, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28626736/enterococcus-spp-and-s-aureus-colonization-in-neutropenic-febrile-children-with-cancer
#4
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/28618307/meta-analysis-of-selected-toxicity-endpoints-of-cdk4-6-inhibitors-palbociclib-and-ribociclib
#5
REVIEW
R Costa, R B Costa, Sarah M Talamantes, Irene Helenowski, Jonna Peterson, Jason Kaplan, B A Carneiro, Francis J Giles, W J Gradishar
PURPOSE: Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors such as palbociclib and ribociclib are associated with distinct adverse effects (AEs) compared to other targeted therapies. This meta-analysis of clinical trials summarizes these agents' toxicity profile. METHODS: A librarian-guided literature search was conducted in March of 2017. The trials needed to have at least one of the study arms consisting of palbociclib or ribociclib monotherapy at currently FDA approved dose regimens...
June 12, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28612451/transplantation-related-toxicity-and-mortality-in-older-autologous-hematopoietic-cell-transplantation-recipients
#6
Hewan Belete, Linda J Burns, Ryan Shanley, Manju Nayar, Brian McClune, Aleksandr Lazaryan, Veronika Bachanova, Nelli Bejanyan, Celalettin Ustun, Claudio Brunstein, Daniel J Weisdorf, Mukta Arora
With advances in supportive care, autologous hematopoietic cell transplant (AHCT) is increasingly being performed for patients older than 60 years. We analyzed patients receiving an AHCT for multiple myeloma or lymphoma in a contemporary cohort (2010-2012), with consistent treatment and supportive care and compared outcomes [CTCAE grade 3-5 toxicities, non-relapse mortality (NRM) and overall-survival (OS)] of younger (40-59 years, n=77) versus older (≥ 60 years, n=67) recipients. The proportion of patients with neutropenic infections was higher in the older group (64% vs...
June 13, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28601903/can-complications-in-febrile-neutropenia-be-predicted-report-from-a-developing-country
#7
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...
June 11, 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
#8
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/28588617/outcomes-of-six-dose-high-dose-cytarabine-as-a-salvage-regimen-for-patients-with-relapsed-refractory-acute-myeloid-leukemia
#9
Brandi Anders, Lauren Veltri, Abraham S Kanate, Alexandra Shillingburg, Nilay Shah, Michael Craig, Aaron Cumpston
Relapsed/refractory acute myeloid leukemia (RR-AML) is associated with poor prognosis and long-term disease-free survival requires allogeneic hematopoietic cell transplantation (allo-HCT). Limited data exists, regarding the optimal regimen to obtain remission prior to allo-HCT. Single agent high-dose cytarabine (10-12 doses administered every 12 hours) has been previously used as induction therapy. Six-dose high-dose cytarabine (HiDAC-6), commonly used as a consolidation regimen, has never been evaluated as induction therapy...
2017: Advances in Hematology
https://www.readbyqxmd.com/read/28584756/disseminated-cutaneous-trichosporonosis-in-an-adult-bone-marrow-transplant-patient
#10
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/28584153/the-use-of-%C3%AE-l-%C3%AE-lis-for-esbl-infections-defining-the-right-patient-population
#11
Pranita D Tamma, Maria Virginia Villegas
In a multicenter, multinational observational study including neutropenic patients with extended-spectrum β-lactamase-producing bloodstream infections, Gudiol and colleagues demonstrate that β-lactam/β-lactamase inhibitors are effective treatment options. A review of this study, however, reminds us that some lingering questions remain for specific high-risk subgroups.
June 5, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28584145/efficacy-of-%C3%AE-lactam-%C3%AE-lactamase-inhibitor-combinations-for-the-treatment-of-bloodstream-infection-due-to-extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-in-hematological-patients-with-neutropenia
#12
Carlota Gudiol, Cristina Royo-Cebrecos, Edson Abdala, Murat Akova, Rocío Álvarez, Guillermo Maestro-de la Calle, Angela Cano, Carlos Cervera, Wanessa T Clemente, Pilar Martín-Dávila, Alison Freifeld, Lucía Gómez, Thomas Gottlieb, Mercè Gurguí, Fabián Herrera, Adriana Manzur, Georg Maschmeyer, Yolanda Meije, Miguel Montejo, Maddalena Peghin, Jesús Rodríguez-Baño, Isabel Ruiz-Camps, Teresa C Sukiennik, Cristian Tebe, Jordi Carratalà
β-lactam/β-lactamase inhibitors (BLBLIs) were compared to carbapenems in two cohorts of hematological neutropenic patients with extended-spectrum β-lactamase (ESBL) bloodstream infection (BSI): the empirical therapy cohort (174 patients) and the definitive therapy cohort (251 patients). The 30-day case-fatality rates and other secondary outcomes were similar in the two therapy groups of the two cohorts, and also in the propensity-matched cohorts. BLBLIs might be carbapenem-sparing alternatives for the treatment of BSI due to ESBLs in these patients...
June 5, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28579084/j%C3%A3-vea-consensus-guidelines-for-the-treatment-of-candida-peritonitis-and-other-intra-abdominal-fungal-infections-in-non-neutropenic-critically-ill-adult-patients
#13
Javier Pemán, Gerardo Aguilar, Juan Carlos Valía, Miguel Salavert, David Navarro, Rafael Zaragoza
BACKGROUND: Although the management of the invasive candidiasis has improved in the last decade, controversial issues yet remain, especially in the diagnostic and therapeutic approaches to Candida peritonitis and other forms of intra-abdominal fungal infections. AIMS: We sought to identify core clinical knowledge about intra-abdominal fungal infections and to achieve high-agreement recommendations required to care for critically ill adult patients with Candida peritonitis and other forms of intra-abdominal fungal infection...
May 31, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28577308/empirical-antibiotics-targeting-gram-positive-bacteria-for-the-treatment-of-febrile-neutropenic-patients-with-cancer
#14
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
https://www.readbyqxmd.com/read/28574735/fatal-course-of-saprochaete-capitata-fungemia-in-children-with-acute-lymphoblastic-leukemia
#15
Zeynep Canan Özdemir, Ayşe Bozkurt Turhan, Yeter Düzenli Kar, Çağrı Ener Dinleyici, Özcan Bör
Saprochaete capitata (S. capitata) is a very rare fungal pathogen that causes disseminated opportunistic infections in patients with hematologic malignancies. Fever resistant to broad-spectrum antibiotic and antifungal treatment is common in the presence of fungemia during the period of profound neutropenia. We describe three cases of leukemic children who died from S. capitata fungemia following a first febrile neutropenic episode after the induction of chemotherapy. S. capitata fungemia is an emergent infection associated with high mortality and low susceptibility to fluconazole and echinocandins...
June 2, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/28566368/caspofungin-increases-fungal-chitin-and-eosinophil-and-%C3%AE-%C3%AE-t-cell-dependent-pathology-in-invasive-aspergillosis
#16
Nansalmaa Amarsaikhan, Ethan M Sands, Anand Shah, Ali Abdolrasouli, Anna Reed, James E Slaven, Darius Armstrong-James, Steven P Templeton
The polysaccharide-rich fungal cell wall provides pathogen-specific targets for antifungal therapy and distinct molecular patterns that stimulate protective or detrimental host immunity. The echinocandin antifungal caspofungin inhibits synthesis of cell wall β-1,3-glucan and is used for prophylactic therapy in immune-suppressed individuals. However, breakthrough infections with fungal pathogen Aspergillus fumigatus are associated with caspofungin prophylaxis. In this study, we report in vitro and in vivo increases in fungal surface chitin in A...
May 31, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28562512/an-unusual-cause-of-fever-and-rash-in-a-child-with-severe-aplastic-anemia
#17
Elis Yuexian Lee, Wen Quan Derrick Lian, Prasad Iyer, Rajat Bhattacharyya
A 4-year-old girl with severe aplastic anemia and 2 previous failed T-depleted haploidentical peripheral blood stem cell transplants developed persistent neutropenic fever and multiple erythematous maculopapular rashes 2 days after her third T-replete haploidentical bone marrow transplant. Skin biopsy confirmed the diagnosis of Trichosporon asahii infection. She was on caspofungin prophylaxis which is not effective against Trichosporon. A high index of suspicion, prompt investigation, and appropriate treatment with voriconazole for 4 months was instrumental in controlling the infection and she remains well presently 9 months posttransplant with full donor chimerism and free from infection...
May 29, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28559256/aerosolized-polymyxin-b-for-treatment-of-respiratory-tract-infections-determination-of-pharmacokinetic-pharmacodynamic-indices-for-aerosolized-polymyxin-b-against-pseudomonas-aeruginosa-in-a-mouse-lung-infection-model
#18
Yu-Wei Lin, Qi Tony Zhou, Nikolas J Onufrak, Veronika Wirth, Ke Chen, Jiping Wang, Alan Forrest, Hak-Kim Chan, Jian Li
Pulmonary administration of polymyxins is increasingly used for the treatment of respiratory tract infections caused by multidrug-resistant Gram-negative bacteria, such as those in patients with cystic fibrosis. However, there is a lack of pharmacokinetics (PK), pharmacodynamics (PD) and toxicity data of aerosolized polymyxin B to inform rational dosage selection. The PK and PD of polymyxin B following pulmonary and intravenous dosing were conducted in neutropenic infected mice and the data were analyzed by a population PK model...
May 30, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28556623/ultrasonography-driven-combination-antibiotic-therapy-with-tigecycline-significantly-increases-survival-among-patients-with-neutropenic-enterocolitis-following-cytarabine-containing-chemotherapy-for-the-remission-induction-of-acute-myeloid-leukemia
#19
Novella Pugliese, Paola Salvatore, Dora Vita Iula, Maria Rosaria Catania, Federico Chiurazzi, Roberta Della Pepa, Claudio Cerchione, Marta Raimondo, Claudia Giordano, Luigia Simeone, Simona Caruso, Fabrizio Pane, Marco Picardi
Neutropenic enterocolitis (NEC) is an abdominal infection reported primarily in patients with acute myeloid leukemia (AML) following chemotherapy, especially cytarabine, a notable efficacious cytotoxic agent for AML remission. Specific data regarding the impact of different cytarabine schedules and/or antibacterial regimens for NEC are sparse. The aim of the study was to identify the predictors of outcome within 30 days of NEC onset. NEC episodes were retrospectively pinpointed among 440 patients with newly diagnosed AML hospitalized in our Institution, over a 10-year period, for receiving chemotherapy protocols with 100-6000 mg/m(2) daily of cytarabine...
May 26, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28555084/mitoxantrone-etoposide-and-cytarabine-mec-following-epigenetic-priming-with-decitabine-in-adults-with-relapsed-refractory-acute-myeloid-leukemia-or-other-high-grade-myeloid-neoplasms-a-phase-1-2-study
#20
A B Halpern, M Othus, E M Huebner, S A Buckley, E L Pogosova-Agadjanyan, K F Orlowski, B L Scott, P S Becker, P C Hendrie, T L Chen, M-Em Percival, E H Estey, D L Stirewalt, R B Walter
DNA methyltransferase inhibitors sensitize leukemia cells to chemotherapeutics. We therefore conducted a phase 1/2 study of mitoxantrone, etoposide, and cytarabine following 'priming' with 5-10 days of decitabine (dec/MEC) in 52 adults (median age 55 [range: 19-72] years) with relapsed/refractory acute myeloid leukemia (AML) or other high-grade myeloid neoplasms. During dose escalation in cohorts of 6-12 patients, all dose levels were well-tolerated. As response rates appeared similar with 7 and 10-days of decitabine, a 7-day course was defined as the recommended phase 2 dose (RP2D)...
May 30, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
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