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Shuzhen Zhang, Sibu Wang, Zhe Wan, Chengli Que, Ruoyu Li, Jin Yu
The diagnosis of invasive pulmonary aspergillosis (IPA) is still in challenge in clinical practice, particularly for those patients without an obvious neutropaenia. In this study, a well-validated qPCR method and Platelia galactomannan (GM) assay were compared for their diagnostic performance using paired samples of bronchoalveolar lavage (BAL) fluid and serum from predominantly non-neutropaenic patients. In the serum samples, qPCR showed a comparable performance with GM assay in terms of sensitivity and specificity...
October 2016: Mycopathologia
R C F Leonard, J L Mansi, C Keerie, A Yellowlees, S Crawford, K Benstead, R Matthew, D Adamson, S Chan, R Grieve
BACKGROUND: Guidelines on the use of haematopoietic colony-stimulating factors for patients having adjuvant chemotherapy for breast cancer are designed to minimise the risk of neutropaenic infection (Smith TJ, Khatcheressian J, Lyman GH et al. Update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 2006; 3: 187-205; Aapro MS, Bohlius J, Cameron DA et al. Effect of primary prophylactic G-CSF use on systemic therapy administration for elderly breast cancer patients...
December 2015: Annals of Oncology: Official Journal of the European Society for Medical Oncology
Ehsan Ghorani, Han Hsi Wong, Carole Hewitt, Joanna Calder, Pippa Corrie, Bristi Basu
OBJECTIVES: The combination of 5-fluorouracil (5-FU), irinotecan and oxaliplatin (FOLFIRINOX) is considered the first-line chemotherapy for fit patients with advanced pancreatic ductal adenocarcinoma (PDAC) but carries an unfavourable adverse event (AE) profile. We retrospectively evaluated the tolerability and efficacy of a modified FOLFIRINOX (mFOLFIRINOX) regimen: intravenous oxaliplatin 85 mg/m2, irinotecan 135 mg/m2, folinic acid 400 mg/m2 and 5-FU infusion 2,400 mg/m2 over 46 h, with routine subcutaneous filgrastim on a 14-day cycle...
2015: Oncology
Madu Anazoeze, Ocheni Sunday, Ibegbulam Obike, Chukwura Awele, Madu Kenechi
BACKGROUND: The absolute neutrophil count (ANC) is currently used to assess immune status of patients on cytotoxic therapy. The CD4 lymphocytes have also been shown to be of importance in protection against opportunistic infections. In people of African descent a low baseline ANC has been recorded and the currently accepted neutropaenic threshold may not be appropriate. OBJECTIVE: This study was aimed at comparing the change in ANC to CD4 lymphocyte count in adult cancer patients following chemotherapy...
June 2015: African Health Sciences
Franz Ratzinger, Helmuth Haslacher, Thomas Perkmann, Klaus G Schmetterer, Wolfgang Poeppl, Dieter Mitteregger, Georg Dorffner, Heinz Burgmann
BACKGROUND: Neutropaenic patients are at a high risk of contracting severe infections. In particular, in these patients, parameters with a high negative predictive value are desirable for excluding infection or bacteraemia. This study evaluated sepsis biomarkers in neutropaenic patients suffering from systemic inflammatory response syndrome (SIRS). Further, the predictive capacities of evaluated biomarkers in neutropaenic SIRS patients were compared to non-neutropaenic SIRS patients. MATERIAL AND METHODS: In this prospective observational cohort study, patients with clinically suspected sepsis were screened...
August 2015: European Journal of Clinical Investigation
Regis Goulart Rosa, Luciano Zubaran Goldani
Septic shock (SS) at the onset of febrile neutropaenia (FN) is an emergency situation that is associated with high morbidity and mortality. The impact of the specific aetiology of bloodstream infections (BSIs) in the development of SS at the time of FN is not well established. The aim of this study was to evaluate the association between the aetiology of BSIs and SS at the time of FN in hospitalised adult cancer patients. This prospective cohort study was performed at a single tertiary hospital from October 2009 to August 2011...
2014: BioMed Research International
F A L M Eskens, P Tresca, D Tosi, L Van Doorn, H Fontaine, A Van der Gaast, C Veyrat-Follet, C Oprea, M Hospitel, V Dieras
BACKGROUND: The vascular disrupting agent ombrabulin shows synergy with docetaxel in vivo. Recommended phase II doses were determined in a dose escalation study in advanced solid tumours. METHODS: Ombrabulin (30-min infusion, day 1) followed by docetaxel (1-h infusion, day 2) every 3 weeks was explored. Ombrabulin was escalated from 11.5 to 42 mg m(-2) with 75 mg m(-2) docetaxel, then from 30 to 35 mg m(-2) with 100 mg m(-2) docetaxel. Recommended phase II dose cohorts were expanded...
April 29, 2014: British Journal of Cancer
Dominic Teichmann, Michelle Cummins, Steven J Keogh, Timothy Rogers
We report the case of a 27-month-old male with an unusual complication of aplastic anaemia and neutropenic enterocolitis. He suffered persistent neutropaenic sepsis and clinical deterioration forced the strategy of matched sibling haematopoietic stem cell transplantation. With engraftment and clinical recovery post-transplant, enteral feeding was re-established. Despite continued improvement the child began to vomit faeculent stomach content. Barium swallow showed gastro-colic and gastro-enteric fistulisation with contrast passing directly from stomach into descending colon and directly into jejunum...
February 2014: Pediatric Blood & Cancer
Michelle Wong, Babilonia Barqasho, Lars Ohrmalm, Thomas Tolfvenstam, Piotr Nowak
In this study we sought to determine the contribution of microbial translocation to febrile episodes with no attributable microbiological cause (Fever of Unknown Origin, FUO) in an adult febrile neutropaenic cohort. Endotoxin concentrations were measured with the chromogenic Limulus Amoebocyte Assay and used as a direct measure of bacterial products whilst soluble CD14 (sCD14), measured with ELISA was selected as an indicator of the early host response to endotoxins. Endotoxin concentrations in this cohort were generally elevated but did not differ with the presentation of fever...
2013: PloS One
R Krause, T Valentin, H Salzer, M Hönigl, A Valentin, H Auner, I Zollner-Schwetz
PURPOSE: Paired blood cultures, drawn from the catheter and a peripheral vein, used for calculation of the differential time to positivity (DTP), have been proposed for the detection of catheter-related bloodstream infections (CRBSIs). The most relevant catheter lumen to be sampled in multi-lumen central venous catheters (CVCs) has not been recommended. METHODS: Forty-four febrile neutropaenic patients, following haematopoietic stem cell transplantation (HSCT) and with multi-lumen CVCs in place, were investigated using the DTP method of blood samples drawn from every lumen of the CVC and a peripheral vein...
February 2013: Infection
Michela Paolucci, Marta Stanzani, Fraia Melchionda, Giulia Tolomelli, Gastone Castellani, Maria Paola Landini, Stefania Varani, Russell E Lewis, Vittorio Sambri
We examined the performance of a real-time polymerase chain reaction (PCR) test (SeptiFast) for early detection of bloodstream infection in febrile neutropaenic patients. Blood samples from 201 patients were screened for pathogens by blood culture and by PCR on the first day of fever. PCR results were available earlier (median 3 days for bacteria, 5 days fungal pathogens; P ≤ 0.01). The sensitivity (0.74) and specificity (0.96) of the PCR test were acceptable for Gram negatives when culture was considered the gold standard, but sensitivity of the test was poorer for Gram-positive organisms (0...
February 2013: Diagnostic Microbiology and Infectious Disease
Michelle Wong, Lars Öhrmalm, Kristina Broliden, Carl Aust, Martin Hibberd, Thomas Tolfvenstam
BACKGROUND: Mannose-binding Lectin protein (MBL) has been suggested to be relevant in the defence against infections in immunosuppressed individuals. In a Swedish adult cohort immunosuppressed from both the underlying disease and from iatrogenic treatments for their underlying disease we investigated the role of MBL in susceptibility to infection. METHODS: In this cross sectional, prospective study, blood samples obtained from 96 neutropaenic febrile episodes, representing 82 individuals were analysed for single nucleotide polymorphism (SNP) in the MBL2 gene...
2012: PloS One
M García-Vargas, M A Casado, N Mir, J A Barrueta
OBJECTIVE: To estimate the cost of 3 candins (anidulafungin, caspofungin and micafungin) in the treatment of adult non-neutropaenic patients with invasive candidiasis (IC) in a Spanish hospital pharmacy setting. METHODS: The overall cost impact was evaluated by varying the percentage dosage required of each candin in different possible scenarios. The prices (in euros) for each presentation were obtained from the Drug Catalogue (in August 2010). Only drug purchase costs were considered...
July 2012: Farmacia Hospitalaria
Mohan Pammi, Peter Brocklehurst
BACKGROUND: Neonates have immature granulopoiesis, which frequently results in neutropenia after sepsis. Neutropaenic septic neonates have a higher mortality than non-neutropenic septic neonates. Therefore, granulocyte transfusion to septic neutropenic neonates may improve outcomes. OBJECTIVES: The primary objective was to determine the effect of granulocyte or buffy coat transfusions as adjuncts to antibiotics, after confirmed or suspected sepsis in neutropenic neonates, on all-cause mortality during hospital stay and neurological outcome at ≥ year of age...
2011: Cochrane Database of Systematic Reviews
E Ramírez, J García-Rodríguez, A M Borobia, J M Ortega, S Lei, A Barrios-Fernández, M Sánchez, A J Carcas, A Herrero, J M de la Puente, J Frías
The purpose of this investigation was to describe the characteristics of the use of systemic antifungal agents (AFAs) and to evaluate their appropriateness of use. A prospective drug-utilisation study was conducted in intensive-care areas: haematology-oncology services and transplant units. Data were collected in three periods over 9 months. The required sample size was determined to be 113 patients (margin of error ±7%, 95% confidence interval [CI]), assuming a variability of 50%. Two different investigator groups evaluated the appropriateness of use separately; Cohen's Kappa index was used to calculate the degree of agreement between groups...
March 2012: European Journal of Clinical Microbiology & Infectious Diseases
Christina Kratzer, Wolfgang Graninger, Andrea Lassnigg, Elisabeth Presterl
Invasive Candida infections are recognised as a cause of increased morbidity and mortality in intensive care patients, particularly those with recent extensive gastroabdominal surgery. Due to the difficulties of diagnosis, several authors have analysed risk factors suggestive of invasive candidiasis to identify patients at highest risk. Such patients may be potential candidates for preemptive antifungal therapy before becoming seriously ill. The extent of body site colonisation due to Candida species was recognised to be related with consequent invasive disease...
November 2011: Mycoses
M Walwyn, A Nicholson, M G Lee, G Wharfe, M A Frankson
BACKGROUNDS: Febrile neutropaenia is a common complication of chemotherapy in cancer patients. Empirical antibiotic regimes are based on the epidemiological characteristics of bacterial isolates globally and locally. METHOD: This study retrospectively reviewed all cases of febrile neutropaenia in patients with confirmed cancer admitted at the University Hospital of the West Indies in the four-year period between, January 1, 2003 and December 31, 2006 and who received chemotherapy...
March 2010: West Indian Medical Journal
G Spizzo, D Öfner, A de Vries, P Lukas, G Steger, U Pluschnig, J Zacherl, J Widder, A Zabernigg, G Gastl, G Mühlmann
BACKGROUND: We conducted a phase II feasibility study using preoperative chemotherapy with cisplatin and docetaxel followed by surgical resection and postoperative chemoradiation in patients with gastric or gastroesophageal cancer. METHODS: Preoperative chemotherapy (two or three cycles) consisted of 50 mg/m(2) docetaxel and 50 mg/m(2) cisplatin. Surgical resection was planned 4 weeks after the last chemotherapy cycle. Patients underwent postsurgical chemoradiation, receiving a total dose of 39...
March 2011: Annals of Surgical Oncology
Stamatis Saoulidis, Maria Simitsopoulou, Maria Dalakiouridou, Thomas J Walsh, L Joseph Wheat, Paraskevi Papaioannidou, Emmanuel Roilides
The aim of this study was to evaluate the pharmacokinetics and efficacy of posaconazole (PSC) in combination with granulocyte colony-stimulating factor (G-CSF) in a neutropaenic murine model of disseminated zygomycosis (mucormycosis) due to Rhizopus microsporus. Male BALB/c mice were rendered neutropaenic with cyclophosphamide (200 mg kg(-1), intraperitoneally) administered on days -1 and +5 postinfection. Mice were infected with R. microsporus (5 × 10(4) spores ml(-1)) intravenously. Mice were treated with PSC (40 mg kg(-1) day(-1) by gavage) or G-CSF (300 μg kg(-1) day(-1) subcutaneously) or with the combination of PSC and G-CSF...
September 2011: Mycoses
Oliver A Cornely, Johan Maertens, Mark Bresnik, Ramin Ebrahimi, Emma Dellow, Raoul Herbrecht, J Peter Donnelly
In 2008, the European Organisation for Research and Treatment of Cancer/Mycoses Study Group (EORTC/MSG) published revised definitions for diagnosing invasive fungal disease. A previous prospective trial of liposomal amphotericin B for invasive mould disease (AmBiLoad) used modified EORTC/MSG 2002 criteria. We wished to re-evaluate the response and survival based on the revised definitions to compare the outcomes of early vs. late treatment. Patients who had received an allogeneic haematopoietic stem cell transplant or who were neutropaenic (absolute neutrophil count <500 μl(-1) within 14 days of study entry) had been recruited on the basis of a halo or air crescent sign on chest computerised tomography...
September 2011: Mycoses
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