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fungal infection and neutropenia

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https://www.readbyqxmd.com/read/28429246/comparison-of-efficacy-and-safety-of-caspofungin-versus-micafungin-in-pediatric-allogeneic-stem-cell-transplant-recipients-a-retrospective-analysis
#1
Natalia Maximova, Giulia Schillani, Roberto Simeone, Alessandra Maestro, Davide Zanon
INTRODUCTION: The high morbidity and mortality associated with invasive fungal infections (IFIs) provide the rationale for antifungal prophylaxis in immuno-compromised pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). Caspofungin and micafungin are antifungal agents of interest for prophylaxis of IFIs because of their potency against Candida and minimal toxicity or interactions with other drugs. Few studies have demonstrated the safety and efficacy of such echinocandins as prophylaxis for IFIs in patients undergoing HSCT...
April 20, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28426102/infection-related-complications-during-treatment-for-childhood-acute-lymphoblastic-leukemia
#2
H Inaba, D Pei, J Wolf, S C Howard, R T Hayden, M Go, O Varechtchouk, T Hahn, J Buaboonnam, M L Metzger, J E Rubnitz, R C Ribeiro, J T Sandlund, S Jeha, C Cheng, W E Evans, M V Relling, C-H Pui
Background: Comprehensive studies on neutropenia and infection-related complications in patients with acute lymphoblastic leukemia (ALL) are lacking. Patients and methods: We evaluated infection-related complications that were grade ≥3 on National Cancer Institute's Common Terminology Criteria for Adverse Events (version 3.0) and their risk factors in 409 children with newly diagnosed ALL throughout the treatment period. Results: Of the 2420 infection episodes, febrile neutropenia and clinically or microbiologically documented infection were seen in 1107 and 1313 episodes, respectively...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28417421/a-review-of-infectious-complications-after-haploidentical-hematopoietic-stem-cell-transplantations
#3
REVIEW
Erden Atilla, Pinar Ataca Atilla, Sinem Civriz Bozdağ, Taner Demirer
BACKGROUND: Allogeneic hematopoietic stem cell transplantation from haploidentical donor is a feasible option for patients with hematological diseases who lack a suitable HLA-matched donor, but viral and fungal infections are still the most common causes of morbidity and mortality in haploidentical transplantation setting because of delayed immune reconstitution, increased risk of graft vs host disease (GvHD) or systemic steroid use. Therefore, this review will focus on the infectious complications after haploidentical hematopoietic stem cell transplantation (HSCT)...
April 17, 2017: Infection
https://www.readbyqxmd.com/read/28413792/epedimiologic-clinical-profile-and-factors-affecting-the-outcome-in-febrile-neutropenia
#4
Kalpathi Krishnamani, Linga Vijay Gandhi, Gundeti Sadashivudu, Digumarti Raghunadharao
BACKGROUND: Febrile neutropenia (FN) is common in cancer patients particularly hematologic malignancies due to intensive cytotoxic chemotherapy. It is an important cause of morbidity, mortality and treatment delays. The risk is greater in patients with ANC < 500/ mm3 and increases dramatically in those with ANC < 100/ mm3 and duration of neutropenia more than 1 week. AIMS AND OBJECTIVES: The purpose of this study was to evaluate the incidence, demographic characteristics, clinical profile, mortality, outcome and factors affecting the outcome in patients with febrile neutropenia (FN) admitted at our Center between January 2011 and November 2012...
January 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28363097/gastrointestinal-emergencies-in-critically-ill-cancer-patients
#5
Delphine Lebon, Lucie Biard, Sophie Buyse, David Schnell, Etienne Lengliné, Camille Roussel, Jean-Marc Gornet, Nicolas Munoz-Bongrand, Laurent Quéro, Matthieu Resche-Rigon, Elie Azoulay, Emmanuel Canet
PURPOSE: To describe gastrointestinal emergencies in cancer patients. METHODS: All cancer patients admitted to the medical ICU of Saint-Louis Hospital for an acute abdominal syndrome during the study period (1997-2011) were included. RESULTS: A total of 164 patients were included. The most common diagnoses were: neutropenic enterocolitis (NE) (n=54, 33%), infectious colitis and peritonitis (n=51, 31%), bowel infiltration by malignancy (n=14, 9%), and mucosal toxicity of chemotherapy (n=12, 7%)...
March 24, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28355465/clinical-considerations-in-the-early-treatment-of-invasive-mould-infections-and-disease
#6
Toine Mercier, Johan Maertens
Different therapeutic strategies for invasive fungal diseases have been explored, each with particular strengths and weaknesses. Broad-spectrum antifungal prophylaxis seems logical, but selective use is important due to its substantial disadvantages, including interference with diagnostic assays, selection for resistance, drug toxicity and drug-drug interactions. Antimould prophylaxis should be restricted to high-risk groups, such as patients undergoing intensive chemotherapy for acute myeloid leukaemia or myelodysplastic syndrome, allogeneic HSCT patients with prior invasive fungal infection, graft-versus-host-disease or extended neutropenia, recipients of a solid organ transplant, or patients with a high-risk inherited immunodeficiency...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28344057/ruxolitinib-as-salvage-therapy-in-steroid-refractory-acute-graft-versus-host-disease-in-pediatric-hematopoietic-stem-cell-transplant-patients
#7
Pooja Khandelwal, Ashley Teusink-Cross, Adam S Nelson, Christopher E Dandoy, Javier El-Bietar, Rebecca A Marsh, Ashish R Kumar, Michael S Grimley, Stella M Davies, Sonata Jodele, Kasiani C Myers
We describe our retrospective clinical experience with ruxolitinib for steroid-refractory acute graft versus host disease (GVHD) in pediatric allogeneic hematopoietic stem cell transplant (HSCT) patients. Ruxolitinib was administered orally at 5 mg twice daily for children ≥ 25 kg or 2.5 mg twice daily if < 25 kg. We excluded patients who received new immune suppressive agents within two weeks before initiation of ruxolitinib from response analysis. Patients were called a treatment failure if ruxolitinib was stopped before completion of 4 weeks of therapy due to adverse effects and not because of progression of acute GVHD...
March 23, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28340200/cytokines-profile-in-immunocompetent-mice-during-trichosporon-asahii-infection
#8
Alexandra M Montoya, Gloria M González, Azalia M Martinez-Castilla, Sonia A Aguilar, Moises A Franco-Molina, Erika Coronado-Cerda, Adrián G Rosas-Taraco
Trichosporon asahii is an opportunistic yeastlike fungus commonly associated with systemic infections in immunocompromised patients. Neutropenia is recognized as the main risk factor in infections by T. asahii; however, little is known about the cytokine response during trichosporonosis. Here, we evaluated systemic and local cytokine production and histological damage in immunocompetent mice during systemic infection with T. asahii. We found a significant increased presence of G-CSF, TNF-α, IFN-γ, and IL-6 in sera samples...
March 15, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28321926/evaluation-of-30-cases-of-mucormycosis-at-a-university-hospital-in-iran
#9
Reza Samarei, Naser Gharebaghi, Salar Zayer
Mucormycosis is a deadly invasive fungal infection and mainly affects immunocompromised patients. To investigate the clinical features of patients who developed mucormycosis and to determine the parameters, which influenced the outcome following mycotic infection. The current investigation retrospectively evaluated the demographic characteristics, clinical features, therapeutic data, as well as the outcomes of treatment in all cases of proven and probable mucormycosis diagnosed from 2002 until 2016 in our hospital...
March 20, 2017: Mycoses
https://www.readbyqxmd.com/read/28295178/granulocyte-transfusions-in-the-management-of-invasive-fungal-infections
#10
REVIEW
Kamille A West, Juan Gea-Banacloche, David Stroncek, Sameer S Kadri
Granulocyte transfusions have a long history of being used in patients with neutropenia or neutrophil dysfunction to prevent and treat invasive fungal infections. However, there are limited and conflicting data concerning its clinical effectiveness, considerable variations in current granulocyte transfusion practices, and uncertainties about its benefit as an adjunct to modern antifungal therapy. In this review, we provide an overview on granulocyte transfusions and summarize the evidence on their role in the prevention and treatment of invasive fungal infections...
May 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28270852/effects-of-honey-on-oral-mucositis-among-pediatric-cancer-patients-undergoing-chemo-radiotherapy-treatment-at-king-abdulaziz-university-hospital-in-jeddah-kingdom-of-saudi-arabia
#11
Soad K Al Jaouni, Mohammad S Al Muhayawi, Abear Hussein, Iman Elfiki, Rajaa Al-Raddadi, Saad M Al Muhayawi, Saad Almasaudi, Mohammad Amjad Kamal, Steve Harakeh
One of the most common complications of cancer chemotherapy is oral mucositis. This study evaluates the therapeutic effects of honey with the focus on grade III and IV oral mucositis, reduction of bacterial and fungal infections, duration of episodes of oral mucositis, and body weight in pediatric leukemic patients undergoing chemo/radiotherapy. This is an open labeled randomized controlled study conducted at our hospital on 40 pediatric cancer patients undergoing chemo/radiotherapy. All the 40 patients included in this study experienced a sum total of 390 episodes of fever and neutropenia associated with oral mucositis...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28243106/ruxolitinib-in-myelofibrosis-to-be-or-not-to-be-an-immune-disruptor
#12
Palma Manduzio
Primary myelofibrosis (PMF) is a myeloproliferative neoplasm classified according to the 2016 revision of World Health Organization Classification of Tumors and Haematopoietic and Lymphoid Tissue. Ruxolitinib is an oral inhibitor of Janus kinase approved in the USA for the treatment of intermediate or high-risk PMF and approved in Europe for the treatment of splenomegaly and constitutional symptoms of the disease. More recently, case reports described serious opportunistic infections in this neoplasm treated with ruxolitinib...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28231567/innate-lung-defense-during-invasive-aspergillosis-new-mechanisms
#13
Jaleesa M Garth, Chad Steele
Invasive aspergillosis (IA) is one of the most difficult to treat and, consequently, one of the most lethal fungal infections known to man. Continued use of immunosuppressive agents during chemotherapy and organ transplantation often leads to the development of neutropenia, the primary risk factor for IA. However, IA is also becoming more appreciated in chronic diseases associated with corticosteroid therapy. The innate immune response to Aspergillus fumigatus, the primary agent in IA, plays a pivotal role in the recognition and elimination of organisms from the pulmonary system...
February 24, 2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28220379/pulmonary-mucormycosis-clinical-features-and-outcomes
#14
Erica Lin, Teng Moua, Andrew H Limper
PURPOSE: Mucormycosis encompasses a group of opportunistic fungal infections caused by Zygomycetes, order Mucorales. Mucormycosis can manifest as rhino-orbito-cerebral, pulmonary, gastrointestinal, cutaneous, and disseminated infections. Pulmonary mucormycosis is the second most common presentation. This manuscript characterizes the demographics, clinical presentation, diagnostic procedures, radiologic findings, therapeutic interventions, and outcome in pulmonary mucormycosis. METHODS: We retrospectively reviewed clinical data of 35 patients with pulmonary mucormycosis from 2000 to 2015...
February 20, 2017: Infection
https://www.readbyqxmd.com/read/28219330/empiric-treatment-against-invasive-fungal-diseases-in-febrile-neutropenic-patients-a-systematic-review-and-network-meta-analysis
#15
Ken Chen, Qi Wang, Roy A Pleasants, Long Ge, Wei Liu, Kangning Peng, Suodi Zhai
BACKGROUND: The most optimal antifungal agent for empiric treatment of invasive fungal diseases (IFDs) in febrile neutropenia is controversial. Our objective was evaluate the relative efficacy of antifungals for all-cause mortality, fungal infection-related mortality and treatment response in this population. METHODS: Pubmed, Embase and Cochrane Library were searched to identify randomized controlled trials (RCTs). Two reviewers performed the quality assessment and extracted data independently...
February 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28217822/how-to-diagnose-early-5-azacytidine-induced-pneumonitis-a-case-report
#16
Srimanta Chandra Misra, Laurence Gabriel, Eric Nacoulma, Gérard Dine, Valentina Guarino
Interstitial pneumonitis is a classical complication of many drugs. Pulmonary toxicity due to 5-azacytidine, a deoxyribonucleic acid methyltransferase inhibitor and cytotoxic drug, has rarely been reported. We report a 67-year-old female myelodysplastic syndrome patient treated with 5-azacytidine at the conventional dosage of 75 mg/m(2) for 7 days. One week after starting she developed moderate fever along with dry cough and subsequently her temperature rose to 39.5 °C. She was placed under broad-spectrum antibiotics based on the protocol for febrile neutropenia, including ciprofloxacin 750 mg twice daily, ceftazidime 1 g three times daily (tid), and sulfamethoxazole/trimethoprim 400 mg/80 mg tid...
December 2017: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/28198173/delphi-based-study-and-analysis-of-key-risk-factors-for-invasive-fungal-infection-in-haematological-patients
#17
L Vázquez, M Salavert, J Gayoso, M Lizasoaín, I Ruiz Camps, N Di Benedetto
OBJECTIVE: Mortality caused by invasive fungal infections due to filamentous fungi (IFI-FF) is high. Predisposing factors to IFI-FF are multiple and should be stratified. The objective of this study was to identify key risk factors for IFI-FF in onco-haematological patients in different clinical settings. METHODS: Prospective national Delphi study. Risk factors for IFI-FF in patients with onco-haematological diseases were identified by a systematic review of the literature...
April 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28194062/performance-of-galactomannan-antigen-beta-d-glucan-and-aspergillus-lateral-flow-device-for-the-diagnosis-of-invasive-aspergillosis
#18
Gökhan Metan, Muzaffer Keklik, Gökçen Dinç, Çiğdem Pala, Afra Yıldırım, Berkay Saraymen, Mustafa Yavuz Köker, Leylagül Kaynar, Bülent Eser, Mustafa Çetin
Aspergillus lateral-flow device (LFD) was recently introduced as a practical tool for the diagnosis of invasive aspergillosis (IA). We investigated the performance of Aspergillus-LFD as a point-of-care test for the diagnosis of IA. Serum samples were collected twice weekly from patients who received intensive chemotherapy for acute leukemia, or recepients of allogeneic stem cell transplantation. Aspergillus galactomannan (GM) antigen, 1,3-beta-d-glucan and Aspergillus-LFD tests were carried out according to manufacturers' recommendations...
March 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28179321/efficacy-and-toxicity-of-induction-therapy-with-cladribine-idarubicin-and-cytarabine-iac-for-acute-myeloid-leukemia
#19
Susan K Woelich, James T Braun, Martin W Schoen, Reshma Ramlal, Carl E Freter, Paul J Petruska, Jack M Lionberger
We report our single-center experience with cytarabine and idarubicin for induction therapy for acute myeloid leukemia (AML) with an additional 5 days of cladribine (IAC therapy). From July 2012 to September 2014, 38 patients completed a full course of IAC induction. Median patient age was 61 years, 61% of patients were ≥60 years old, and 71% were male. The complete remission (CR) rate was 63% following a single induction course, three patients (8%) required a second induction course to achieve CR, for an overall response rate of 71%...
2017: Anticancer Research
https://www.readbyqxmd.com/read/28150341/invasive-infections-due-to-saprochaete-and-geotrichum-species-report-of-23-cases-from-the-fungiscope-registry
#20
Luisa Durán Graeff, Danila Seidel, Maria J G T Vehreschild, Axel Hamprecht, Anupma Kindo, Zdenek Racil, Judit Demeter, Sybren De Hoog, Ute Aurbach, Maren Ziegler, Hilmar Wisplinghoff, Oliver A Cornely
Saprochaete and Geotrichum spp. are rare emerging fungi causing invasive fungal diseases in immunosuppressed patients and scarce evidence is available for treatment decisions. Among 505 cases of rare IFD from the FungiScope(™) registry, we identified 23 cases of invasive infections caused by these fungi reported from 10 countries over a 12-year period. All cases were adults and previous chemotherapy with associated neutropenia was the most common co-morbidity. Fungaemia was confirmed in 14 (61%) cases and deep organ involvement included lungs, liver, spleen, central nervous system and kidneys...
April 2017: Mycoses
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