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fungal infection and neutropenia

Chunyan Yue, Yingying Ding, Yang Gao, Li Li, Yan Pang, Zenghui Liu, Hang Zhang, Yang Xiao, Zujun Jiang, Haowen Xiao
OBJECTIVES: In patients with very severe aplastic anemia (VSAA), neutropenia is prolonged and persistent, resulting in refractory overwhelming infections. Hematopoiesis recovery is urgently needed. METHODS: Six patients with de novo VSAA lacking HLA-identical sibling donors and those who experienced refractory infections, underwent haploidentical related donor (HRD) hematopoietic stem cell transplantation (HSCT) as a first-line therapy. The conditioning regimen consisted of busulfan, cyclophosphamide and rabbit antithymocyte globulin...
March 12, 2018: European Journal of Haematology
Tilly Varughese, Ying Taur, Nina Cohen, M Lia Palomba, Susan K Seo, Tobias M Hohl, Gil Redelman-Sidi
Background: Ibrutinib is a Bruton's tyrosine kinase inhibitor that is used for the treatment of lymphoid malignancies, including chronic lymphocytic leukemia (CLL), Waldenström's macroglobulinemia and mantle cell lymphoma (MCL). Several case series have described opportunistic infections among ibrutinib recipients, but the full extent of these infections is unknown. We sought to determine the spectrum of serious infections associated with ibrutinib treatment. Methods: We reviewed the electronic medical records of patients with lymphoid malignancies at Memorial Sloan Kettering Cancer Center who received ibrutinib during a five-year period from January 1, 2012 to December 31, 2016...
March 2, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Dilek Gurlek Gokcebay, Sibel Akpinar Tekgunduz
Severe neutropenia-associated invasive bacterial or fungal infections are still the major cause of mortality and morbidity in children receiving cancer chemotherapy. Granulocyte transfusion therapy has been used for many years in the management of neutropenic patients with severe infections in whom the clinical condition deteriorated despite appropriate antimicrobial treatment. Transfused granulocytes can increase the recipient's blood neutrophil count and accumulation of them into the site of infection. There are some data obtained from retrospective or prospective observational studies in pediatric granulocyte transfusion therapy, but results are not conclusive...
February 20, 2018: Transfusion and Apheresis Science
David Ghez, Anne Calleja, Caroline Protin, Marine Baron, Marie-Pierre Ledoux, Gandhi Damaj, Mathieu Dupont, Brigitte Dreyfus, Emmanuelle Ferrant, Charles Herbaux, Kamel Laribi, Ronan Le Calloch, Marion Malphettes, Franciane Paul, Laetitia Souchet, Malgorzata Truchan-Graczyk, Karen Delavigne, Caroline Dartigeas, Loïc Ysebaert
Ibrutinib has revolutionized the management of chronic lymphocytic leukemia and is now being increasingly used. Although considered to be less immunosuppressive than conventional immunochemotherapy, the observation a few cases of invasive fungal infections in patients treated with ibrutinib prompted us to conduct a retrospective survey. We identified 33 cases of invasive fungal infections in patients receiving ibrutinib alone or in combination. Invasive aspergillosis was overrepresented (27/33) and was associated with cerebral localizations in 40% of the cases...
February 1, 2018: Blood
Marco Fiore, Marco Cascella, Sabrina Bimonte, Alberto Enrico Maraolo, Ivan Gentile, Vincenzo Schiavone, Maria Caterina Pace
Fungal infections of the liver, most commonly caused by Candida spp., often occur in patients with hematologic malignancies treated with chemotherapy. Colonization of the gastrointestinal tract is thought to be the main origin of dissemination of Candida ; mucositis and neutropenia facilitate the spread of Candida from the gastrointestinal tract to the liver. Hepatic involvement due to other fungi is a less common infectious complication in this setting. Fungal infections represent a less common cause of hepatic abscesses in non-oncohematologic population and the trend appears to be decreasing in recent years...
2018: Infection and Drug Resistance
Roberta Di Blasi, Chiara Cattaneo, Russell E Lewis, Mario Tumbarello, Laura Angelici, Giulia Dragonetti, Alessandro Busca, Benedetta Cambò, Anna Candoni, Monica Cesarini, Simone Cesaro, Mario Delia, Rosa Fanci, Francesca Farina, Mariagrazia Garzia, Antonio Giordano, Bruno Martino, Lorella Melillo, Gianpaolo Nadali, Vincenzo Perriello, Marco Picardi, Angela Maria Quinto, Prassede Salutari, Angelica Spolzino, Adriana Vacca, Calogero Vetro, Michelle Zancanella, Annamaria Nosari, Franco Aversa, Livio Pagano
The purpose of the present study is to estimate the current incidence of febrile events (FEs) and infectious episodes in acute lymphoblastic leukemia (ALL) and evaluate the outcome. We analyzed data on all FEs in a cohort of patients affected by ALL admitted to 20 Italian hematologic centers during 21 months of observation from April 1, 2012 to December 31, 2013. Data about treatment phase, steroids, neutropenia, type and site of infection, and outcome of infection were collected. The population comprehended 271 ALL adult patients...
February 7, 2018: Annals of Hematology
Maria N Gamaletsou, Thomas J Walsh, Nikolaos V Sipsas
Invasive fungal infections caused by drug-resistant organisms, are an emerging threat to heavily immunosuppressed patients with haematological malignancies. Modern early antifungal treatment strategies, such as prophylaxis, empirical and pre-emptive therapy result in long term exposure to antifungal agents, which is a major driving force for the development of resistance. The extended use of central venous catheters, the non-linear pharmacokinetics of certain antifungal agents, neutropenia, other forms of intense immunosuppression, and drug toxicities are other contributing factors...
February 2, 2018: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
Jesus A Chavez, Daniel J Brat, Steven B Hunter, Jose Velazquez Vega, Jeannette Guarner
Objectives: Early and accurate diagnosis remains crucial in the therapeutic management of invasive central nervous system fungal infections. Different molds have intrinsic resistance to antifungal agents; thus, morphologic differentiation is helpful to clinicians. Methods: Using three examples, we present a guide on how to approach neuropathology specimens where hyphae are identified on initial histologic examination. Results: Hyphae can be classified into three basic groups: hyaline pauciseptated, hyaline septated, and pigmented or dematiaceous...
January 20, 2018: American Journal of Clinical Pathology
Raffaella Greco, Maria Chiara Barbanti, Nicasio Mancini, Lara Crucitti, Chiara Oltolini, Alessandra Forcina, Francesca Lorentino, Luca Vago, Carlo Messina, Daniela Clerici, Mara Morelli, Fabio Giglio, Maria Teresa Lupo Stanghellini, Laura Infurnari, Matteo G Carrabba, Sarah Marktel, Andrea Assanelli, Paolo Scarpellini, Massimo Bernardi, Jacopo Peccatori, Consuelo Corti, Massimo Clementi, Fabio Ciceri
Febrile neutropenia and sepsis are common and life-threatening complications in hematological diseases. This study was performed retrospectively in 514 patients treated for febrile neutropenia at our institute, to investigate the clinical usefulness of a molecular tool, LightCycler® SeptiFast test (SF), to promptly recognize pathogens causing sepsis in hematological patients. We collected 1837 blood samples of 514 consecutive hematological patients. The time of processing is short. Overall, 757 microorganisms in 663 episodes were detected by molecular test and standard blood cultures (BC): 73...
January 12, 2018: Bone Marrow Transplantation
Kumpol Aiempanakit, Surarit Naorungroj, Kanokphorn Chiratikarnwong, Sauvarat Auepemkiate, Benjawan Apinantriyo
Background: Febrile neutropenia (FNP) is a condition defined by fever and neutropenia. There are current only limited data on related cutaneous manifestations. This study aimed to assess cutaneous lesions and their etiologies in a Thai group of FNP patients. Methods: A retrospective analysis was conducted on 43 non-transplant febrile neutropenic patients with concurrent cutaneous lesions, as determined by dermatopathologic studies at Songklanagarind Hospital in Thailand over a five-year period. Results: The mean age was 39 years (SD: 18...
December 29, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
Amin T Turki, Jassin Rashidi-Alavijeh, Jan Dürig, Guido Gerken, Peter-Michael Rath, Oliver Witzke
BACKGROUND: Invasive aspergillosis involving patients with neutropenia or severe immunosuppression, such as patients with hematologic malignancies is associated with high mortality. Patients with T-cell large granular lymphocytic leukemia (T-LGL) on the other hand are considered to be less vulnerable for severe opportunistic fungal infection as their course of disease is chronic and marked by less violent cytopenia then in e.g. Aplastic Anemia. Only neutropenia is regarded as independent risk factor for severe opportunistic infection in T-LGL patients...
December 28, 2017: BMC Infectious Diseases
Pei-Fen Zhang, Xiao-Qin Feng, Cui-Ling Wu, Yu-Ming Zhang
OBJECTIVE: To examine the clinical features of children with acute lymphoblastic leukemia (ALL) complicated by pulmonary infection after chemotherapy. METHODS: The clinical data of 108 ALL children (115 case-times) with post-chemotherapy pulmonary infection were retrospectively reviewed. The risk factors for pulmonary infection and the relationship between pathogens and chest CT findings were evaluated. RESULTS: The highest incidence (77.4% ) of pulmonary infection occurred during remission induction, peaking at 31-60 days after chemotherapy...
December 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Jason E Gilde, Christopher C Xiao, Victoria A Epstein, Jonathan Liang
INTRODUCTION: Acute invasive fungal rhinosinusitis (AIFRS) is a potentially fatal infection, usually affecting immunocompromised patients. Isolated sphenoid sinus involvement is rare and has been reported in only a few cases. We discuss the clinical characteristics, histopathologic features, and differential diagnosis of AIFRS of the sphenoid sinus. CASE PRESENTATION: A 57-year-old man with a history of refractory non-Hodgkin lymphoma and neutropenia presented with a 1-week duration of left-sided headache and ipsilateral cheek paresthesia...
2017: Permanente Journal
Sibylle C Mellinghoff, Jens Panse, Nael Alakel, Gerhard Behre, Dieter Buchheidt, Maximilian Christopeit, Justin Hasenkamp, Michael Kiehl, Michael Koldehoff, Stefan W Krause, Nicola Lehners, Marie von Lilienfeld-Toal, Annika Y Löhnert, Georg Maschmeyer, Daniel Teschner, Andrew J Ullmann, Olaf Penack, Markus Ruhnke, Karin Mayer, Helmut Ostermann, Hans-H Wolf, Oliver A Cornely
Immunocompromised patients are at high risk of invasive fungal infections (IFI), in particular those with haematological malignancies undergoing remission-induction chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) and recipients of allogeneic haematopoietic stem cell transplants (HSCT). Despite the development of new treatment options in the past decades, IFI remains a concern due to substantial morbidity and mortality in these patient populations. In addition, the increasing use of new immune modulating drugs in cancer therapy has opened an entirely new spectrum of at risk periods...
February 2018: Annals of Hematology
Umabala Pamidimukkala, Anuradha Kancharla, Sukanya Sudhaharan, Sadashivudu Gundeti, Surendra Mandarapu, Vamsi Krishna Nagalla, Sree Bhushan Raju, Sandhya Devi Karanam
Introduction: Saprochaete capitata (Teleomorph: Magnusiomyces capitatus ) is a ubiquitous yeast found in environmental sources such as soil, water, air, plants and dairy products. It is also a part of the normal microbial flora in humans. The yeast is being increasingly reported as an opportunistic pathogen, especially in patients in the haemato-oncology setting, the infection being often mistakenly diagnosed as invasive candidiasis. Aim: To review the epidemiological, clinical and microbiological features of six patients admitted in our hospital over a period of 10 years (from January 2007 to December 2016), from whom Saprochaete capitata was isolated...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
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...
August 2017: Pediatric Hematology and Oncology
Sivan Berger-Achituv, Ronit Elhasid
Data on the production of neutrophil extracellular traps (NETs) in leukemia patients are scant. Phagocytosis, hydrogen peroxide, neutrophil elastase and myeloperoxidase enzymatic activity as well as NETs formation were studied in 10 pediatric acute lymphoblastic leukemia and 7 pediatric acute myeloid leukemia (AML) patients after induction chemotherapy. Median neutrophil elastase activity and NETs formation were lower in AML versus acute lymphoblastic leukemia (41% vs. 90%, P=0.005 and 51% vs. 94%, P=0.008, respectively)...
December 1, 2017: Journal of Pediatric Hematology/oncology
Jasna Radich R, Carlos Álvarez Z, Ana Valenzuela R, Felipe Castillo H, Francisco Moraga V, Jorge Castillo A
Saprochaete capitata (S. capitata) fungal sepsis is a severe condition with a clinical presentation that is similar to other yeast originated fungal sepsis. It is observed in patients with hematological malignancies such as acute myeloid leukemia and neutropenia. We report a 23 year old male presenting with cough, fever and malaise. A bone marrow biopsy led to the diagnosis of acute myeloid leukemia. During the first cycle of chemotherapy the patient presented fever: blood cultures were positive for Klebsiella pneumoniae...
August 2017: Revista Médica de Chile
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
Sumiko Kohashi, Takaaki Toyama, Norisato Hashimoto, Masatoshi Sakurai, Jun Kato, Taku Kikuchi, Yuya Koda, Kayoko Sugita, Naoki Hasegawa, Kyoko Yarita, Katsuhiko Kamei, Shinichiro Okamoto, Takehiko Mori
Invasive fungal disease is a serious infectious complication of allogeneic hematopoietic stem cell transplantation (HSCT). Exserohilum rostratum is a species causing phaeohyphomycosis, which rarely causes invasive disease in humans. We treated a case of sinusitis caused by E. rostratum after cord blood transplantation (CBT). A 60-year-old man with myelodysplastic syndrome, who had a medical history of an operation to correct deviation of the nasal septum, developed sinusitis caused by E. rostratum under prolonged profound neutropenia after a second CBT because of the graft rejection of the first transplantation...
November 8, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
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