Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The isolation of Aspergillus species from respiratory secretions has been regarded as being of limited usefulness in the antemortem diagnosis of invasive pulmonary aspergillosis. One hundred and eight consecutive patients were evaluated in whom Aspergillus species were isolated from respiratory secretions. Invasive aspergillosis was not demonstrated in non-immunosuppressed patients or in patients with solid tumors in the absence of neutropenia. Lung tissue was examined in 17 patients with leukemia and/or neutropenia; all had invasive aspergillosis. Tissue examination was not performed in 20 neutropenic patients; of 17 not receiving antifungal therapy, 16 died. Multivariate statistical analysis showed that neutropenia and absence of cigarette smoking were significant predictors of invasive aspergillosis in patients with respiratory tract cultures yielding Aspergillus. All cases of invasive aspergillosis were associated with A. fumigatus or A. flavus. The isolation of A. fumigatus or A. flavus from the respiratory tract of a patient with leukemia and/or neutropenia is highly predictive of invasive infection. Empiric amphotericin B therapy, without the necessity for tissue diagnosis, should be considered in this patient subgroup.
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PMID:Significance of isolation of Aspergillus from the respiratory tract in diagnosis of invasive pulmonary aspergillosis. Results from a three-year prospective study. 309 Aug 79

Aspergillus terreus is an uncommon cause of human disease. A patient with acute myelomonocytic leukemia is described who developed an invasive pulmonary infection with A terreus characterized by an air-crescent sign on chest roentgenogram. Previous reports of A terreus infections and the pathogenesis and significance of an air-crescent sign in invasive pulmonary aspergillosis are reviewed.
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PMID:Aspergillus terreus causing invasive pulmonary aspergillosis with air-crescent sign. 345 27

One case of invasive aspergillosis in patient with myeloblastic leukemia probably induced by chimiotherapy is reported. Aspergillosis is a severe infection in immunodepressed host with 70 to 80% of mortality. Early diagnosis can be often carried by broncho-alveolar lavage, route of entry is always pulmonary one. Rapidly established antimycotic treatment can avoid death. Laminar air flow rooms and air spores numeration allow prevention of this infection in the immunodepressed host.
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PMID:[Disseminated aspergillosis in acute leukemia probably chemically-induced]. 347 Jul 7

A 46-year-old man presented with nodular skin lesions, a biopsy specimen of which demonstrated a poorly differentiated malignancy. Touch preparations with histochemical staining and electron microscopy confirmed leukemia cutis. Results from a bone marrow aspirate disclosed focal areas of increased myeloblasts, and cytogenetic analysis revealed an abnormal karyotype as follows 46,XY, t(1;2) (q44p13). Antileukemic therapy resulted in prompt disappearance of the skin nodules, and a return of the patient's bone marrow to normal was noted, but after six months of intensive chemotherapy leukemia cutis recurred without morphologically identifiable leukemia in the bone marrow. The patient underwent successful bone marrow transplantation from an HLA-identical sibling but died 70 days after the transplant from disseminated aspergillosis.
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PMID:Aleukemic leukemia cutis. 372 13

The clinicopathologic characteristics of orofacial aspergillosis in thirteen hospitalized patients who developed the infection while receiving chemotherapy for acute leukemia are described. Clinically, the primary sites of infection, in decreasing order of frequency, were the paranasal sinuses, nasal cavity, mouth, and facial skin; the corresponding order for the secondary sites was orbit, nasal cavity, facial skin, and mouth. Pathologically, the fungal lesions in the nasal, oral and sinusoidal cavities were black, ulcerated, and escharotic due as a direct result of tissue destruction by the organism and an indirect result of thrombotic vascular infarction. The orbital lesions were deep red, granulomatous, and productive of proptosis and ectropion. Seven of the thirteen patients had concomitant pulmonary aspergillosis. The orofacial infections were not responsive to antifungal therapy in the absence of remission of the leukemia and restoration of depressed host defenses. In two patients who did achieve remission, the aspergillosis was controlled by the intravenous administration of amphotericin B.
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PMID:Orofacial aspergillosis in acute leukemia. 385 9

Among 78 patients who died after bone marrow transplantation, neurologic complications were present in 55 (70%) and were the cause of death in 5 (6%). Metabolic encephalopathy occurred in 29 patients (37%). CNS infections included aspergillosis (3), herpes simplex encephalitis (2), and Listeria monocytogenes meningitis (1). Six additional patients had neuropathologic changes possibly due to cytomegalovirus infection. Cerebrovascular complications occurred in five patients (two hemorrhages and three infarcts). All infarcts were associated with endocarditis. The rate of nonbacterial thrombotic endocarditis was significantly higher (p less than 0.001) than in the general autopsy population. CNS leukemia and therapy-induced injury were rare. There was no evidence of graft-versus-host disease involving the CNS.
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PMID:Neurologic complications of bone marrow transplantation. 388 33

The clinical, laboratory, and pathological features of aspergillosis of the central nervous system (CNS) were studied in a series of 17 autopsied patients. Two groups were defined. Group A consisted of 8 patients with diseases commonly associated with CNS aspergillosis: leukemia, lymphoma, aplastic anemia, and renal transplantation. Group B contained 9 patients with various illnesses not generally known to be associated with CNS aspergillosis. CNS aspergillosis was diagnosed and treated before death in only 1 patient. Patients in Group A received cytotoxic drugs, often had granulocytopenia, less commonly had focal neurological deficits, and seldom had seizures. Group B patients were not granulocytopenic, received no cytotoxic agents, underwent nontransplant surgery, and more frequently had focal neurological deficits. Eleven of the 17 patients (65%) had focal deficits, most of them hemiparesis. Meningeal signs were rare, but the cerebrospinal fluid was usually abnormal. The principal neuropathological process was Aspergillus invasion of blood vessels causing hemorrhagic infarction. Focal clinical deficits correlated neuroanatomically with Aspergillus lesions. In 2 patients, such lesions were detected by 99mTc-DTPA or cerebral angiography before computed tomographic scanning. The lungs were the usual portal of entry, but isolated CNS lesions occurred in 2 patients. CNS aspergillosis should be considered as a cause of new onset of focal neurological deficits in patients with illnesses that are more diverse than has generally been appreciated.
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PMID:Aspergillosis of the central nervous system: clinicopathological analysis of 17 patients. 393 42

Invasive aspergillosis of the nose and paranasal sinuses is one of the presentations of aspergillosis in granulocytopenic patients with neoplastic disorders. It is most prevalent among patients with leukemia and granulocytopenia and is associated with a high mortality rate. We report five cases of invasive aspergillosis of the nose and paranasal sinuses in profoundly neutropenic patients treated with broad spectrum antibiotics. Both Aspergillus fumigatus and Aspergillus flavus were cultured and identified in this entity. Awareness of this disease and early diagnosis made by culture and histologic examinations of biopsy material are essential. Treatment consisting of amphotericin B therapy and surgical debridement can be effective in eradicating this form of aspergillosis.
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PMID:Aspergillosis of the nose and paranasal sinuses in neutropenic patients at an oncology center. 393 5

Of 590 autopsies during the period 1976 to 1983 in patients with leukaemia and malignant lymphomas there were 89 cases (15%) involving deep-seated mycoses. In the last three years the frequency of mycotic infections has risen considerably even though effective drugs are available today. The increase occurred particularly in acute leukaemias but was also found in chronic myelogenous leukaemias and in cases with high-malignancy non-Hodgkin lymphomas. An opportunistic fungal infection in Hodgkin's disease and in patients with plasmocytoma was rare. Candidosis and aspergillosis predominated histologically. About 70% of deep-seated mycoses were severe infections having a decisive influence on the course of the disease. On the basis of this retrospective analysis it can be concluded that the occurrence of mycoses is influenced, first and foremost, by 3 factors: 1. The antineoplastic therapy 2. The nature of the underlying disease 3. The intensity of the supportive measures.
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PMID:[Deep mycoses in leukemias and malignant lymphomas]. 399 33

The air crescent sign is regarded as an important diagnostic finding in invasive pulmonary aspergillosis (IPA). This study examined the incidence, clinical importance, and natural history of air crescents in 25 patients with acute leukemia and IPA. Twelve (50%) of the patients had cavities (ten with an air crescent) that appeared an average of 15 days after the initial infiltrate. The diagnostic utility of the air crescent sign was relatively minor; cavities developed after the diagnosis was established in 50% of cases and after therapy was started in 75% of cases. In each case, the pneumonia improved at the time of cavitation. In six patients (50%), the cavities resolved over 2-8 months. Three patients (25%), however, experienced massive hemoptysis. Air crescent formation, previously shown to be dependent on granulocyte recovery, was associated with improved survival (67%) compared with the group without cavitation (8%). In the latter group, the pneumonia in ten (77%) of 13 patients progressed to diffuse disease. In patients with leukemia, the diagnostic value of the air crescent sign is limited by cavities that develop relatively late, as the infection improves after white blood cell recovery; cavities that do not occur in patients who remain neutropenic; and associated hemorrhage, at times life-threatening, that obscures the air crescent. The diagnosis of IPA should not await observation of air crescents in these patients.
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PMID:Invasive pulmonary aspergillosis and acute leukemia. Limitations in the diagnostic utility of the air crescent sign. 405 47


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