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)

In order to clarify the present state of terminal pulmonary infections, all autopsy cases from 1976 to 1985 reported in the annual records of autopsy cases in Kyushu University Hospital were reviewed. Of the total of 2,238 autopsy cases, pulmonary infections were present in 1,042 (46.6%) and in 595 (26.6%) pulmonary infections were fatal. Among the primary diseases associated with pulmonary infections, hematologic diseases such as leukemia and malignant lymphoma, lung cancer, esophageal cancer and cerebrovascular disease were most frequent. The pathogens of fatal pulmonary infections occurring in autopsy cases were bacteria (26.6%), Aspergillus (3.2%), Candida (1.8%), cytomegalovirus (1.7%), Pneumocystis carinii (1.1%), Mycobacterium (0.9%), Cryptococcus (0.6%) and phycomycetes (0.1%). The incidence of non-bacterial, especially fungal, pulmonary infections has increased during the recent five-year period. Among the pulmonary infections associated with lung cancer in autopsy cases, mycobacteriosis occurred more frequently than fungal infection. The incidence of fatal mycobacteriosis was more frequent in cases receiving steroids than in those not receiving steroids. Antemortem diagnosis of pulmonary infections was made in only 4.6% and 26.3% of cases of non-bacterial infection and mycobacteriosis, respectively. There was no autopsy case diagnosed before death as aspergillosis, which most frequently occurred among the fungal pulmonary infections in autopsy cases.
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PMID:[Autopsy cases of terminal pulmonary infections]. 274 58

We evaluated retrospectively the incidence and prognosis of bacteremias after bone marrow transplantation treated in protected environment with intestinal decontamination. Bacteremias are more frequent during the extreme granulopenia (55% of the patients) than during recovery of granulocyte counts greater than 500/mm3 (35% of the patients). Gram + organisms are more frequently responsible of bacteremias (80%), mainly Staphylococcus epidermidis and Streptococci. Mortality is low (7%) and related to additional factors like GVH, resistant leukemia. These data invite to develop new approaches of prevention of bacterial infection, with measures possibly efficient on Gram + organisms.
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PMID:[Bacteremias after bone marrow grafts in a protected environment: effects, various aspects and prognosis]. 305 71

Bone marrow transplantation (BMT) after intensive marrow-lethal chemotherapy and total body irradiation has made remarkable progress in recent years. In allogeneic BMT, HLA-matched marrow cells of siblings are used, while in autologous BMT, cryopreserved leukemia-purged marrow cells from patients are employed. In 1985, about 100 BMT cases were registered in the Japan BMT study group. Interstitial pneumonitis caused by cytomegalovirus, relapse of leukemia, graft versus host disease, and bacterial infection were major cases of failure, which have shown a markedly reduced tendency in recent years. The timing of BMT was found to be very important for the survival of patients. In cases with acute lymphoblastic leukemia, if BMT was performed in the first remission, the long survival rate was 76%, while this rate was low for second or subsequent remissions. It was also found in patients with chronic myelogenous leukemia, that the survival rate was high in the chronic phase and low in the accelerated or blastic phase. BMT seems to be a very promising therapy for leukemia and related malignant diseases with a very high possibility of complete cure.
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PMID:[Bone marrow transplantation after intensive chemotherapy]. 329 59

We conducted a randomized, double-blind, placebo-controlled study to evaluate the efficacy of oral trimethoprim/sulfamethoxazole (TMP/SMX) in the prevention of bacterial infections in children with cancer. Sixty-three patients with acute leukemia were studied during the induction phase of chemotherapy; 28 patients with solid tumors who were starting intensive chemotherapy were also enrolled and treated for 2 months. There was no significant difference in the frequency of febrile episodes between the 43 children receiving trimethoprim/sulfamethoxazole and the 48 receiving placebo. However, when the group of 74 children who experienced granulocytopenia (absolute granulocyte count less than 500/microL) was analyzed separately, significant reductions in the frequencies of confirmed bacteremia (2.6% v 20.0%, P = .02) and febrile episodes (35.9% v 65.7%, P = .01) were observed in the trimethoprim/sulfamethoxazole group. Furthermore, life table analysis showed that children with leukemia receiving trimethoprim/sulfamethoxazole had significantly more days without fever and without bacteremia. No benefits from prophylaxis were recognized in the subgroup with solid tumors. Although the frequency of oral thrush was greater (P = .02) in the trimethoprim/sulfamethoxazole group (25.6%) than in the placebo group (6.3%), invasive fungal infection did not occur. Although the mean duration of granulocytopenia was greater among those receiving trimethoprim/sulfamethoxazole (13.7 v 9.0 days, P = .05), this did not appear to increase the overall risk for bacterial infection. These data suggest that trimethoprim/sulfamethoxazole reduces the frequency of bacteremia and febrile episodes in granulocytopenic children undergoing induction chemotherapy for acute leukemia.
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PMID:Oral trimethoprim/sulfamethoxazole for prevention of bacterial infection during the induction phase of cancer chemotherapy in children. 390 47

43 patients undergoing treatment for acute leukaemia were randomised to receive either co-trimoxazole alone or co-trimoxazole with framycetin and colistin as antibacterial prophylaxis during periods of neutropenia. There were no significant differences between the two treatment groups in the time before the onset of the first fever, the number of episodes of fever or of septicaemia per patient, the number of neutropenic days during which patients remained afebrile or did not require systemic antibiotics, or the number of resistant organisms acquired. Co-trimoxazole alone is cheaper and easier to take than co-trimoxazole with framycetin and colistin, and it is therefore preferable to the three-drug combination for the prophylaxis of bacterial infection.
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PMID:Co-trimoxazole alone for prevention of bacterial infection in patients with acute leukaemia. 611 43

In an attempt to reduce the incidence of fever and infection, we randomized patients with cancer to receive trimethoprim/sulfamethoxazole plus erythromycin (TMP/SMX + E) versus placebos after each cycle of chemotherapy (no crossover) and to continue until granulocytopenia (polymorphonuclear leukocytes less than 500/mm3) resolved or the patient became febrile. We evaluated 541 episodes (150 patients); 249 episodes (77 patients) with TMP/SMX + E and 292 episodes (73 patients) with placebos. The patients' median age was 17 years. Thirty percent of the patients had leukemia, 23% had lymphoma, and 47% had solid tumors. Compliance with prescribed medication was prospectively rated as excellent in 60.6%, good in 11.7%, poor in 11.1%, and unknown in 16.6%; compliance was better for the placebo group (P = 0.001). The overall incidence of fever or infection was 22.1% for the TMP/SMX + E group versus 26.9% for the placebo group. When only episodes with excellent compliance in which granulocytopenia was documented were compared, the incidence of fever or infection was 18.1% for the TMP/SMX + E group vs 32.2% for the placebo group (P = 0.009), with bacterial infection occurring in 3.8% of the TMP/SMX + E group vs 11.9% of the placebo group (P = 0.019), and unexplained fever in 10.5% of the TMP/SMX + E group vs 19.6% of the placebo group (P = 0.037). Patients with good or poor compliance showed no significant benefit from the TMP/SMX + E, and patients with excellent compliance did best, regardless of whether they were receiving antibiotics or placebos, suggesting that patient compliance is an important independent variable. The incidence of fever or infection was significantly lower for patients with leukemia with excellent compliance who received antibiotics (P = 0.037) than for patients with lymphomas or solid tumors. Oral antibiotic prophylaxis reduced the incidence of fever and infection in some granulocytopenic patients, but the benefit was limited and restricted to patients whose compliance was complete.
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PMID:Oral antibiotic prophylaxis in patients with cancer: a double-blind randomized placebo-controlled trial. 633 81

Thirty-six patients received allogeneic (34) or syngeneic (two) bone marrow transplants as treatment for severe aplastic anaemia or acute leukaemia. Nineteen of the allogeneic recipients received methotrexate (MTX) and 15 received cyclosporin A (CyA) as the predominant immunosuppressive agent to minimize graft-versus-host disease (GVHD) post transplant. In the first 100 d post transplant renal dysfunction was much less frequent in the MTX recipients than in the CyA recipients who exhibited three distinct syndromes of nephrotoxicity: most commonly. CyA recipients developed asymptomatic azotaemia, proteinuria, urinary casts, impaired urinary concentrating ability and hypertension. Secondly, two CyA recipients developed acute reversible renal failure precipitated by systemic bacterial infection which required dialysis and in which the kidney was the sole target organ; thirdly, two recipients of HLA-genotypically non-identical grafts developed a rapidly progressive fatal syndrome with multiple organ involvement including lung, brain and kidney which clinically and histologically resembled thrombotic thrombocytopenic purpura.
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PMID:Cyclosporin A associated nephrotoxicity in the first 100 days after allogeneic bone marrow transplantation: three distinct syndromes. 634 55

Since 1976, 16 adult patients with acute leukemia have been treated by chemotherapy, total body irradiation (TBI) and allogeneic bone marrow transplantation (BMT) in the medical school hospital and the satellite hospitals of Nagoya University. The first group of 10 patients were given marrow grafts at the time of leukemic relapse and the second group of six patients were given the grafts in the period of remission of their disease. For the first group (ALL/ANLL 2:8, age (median) 33, M/F 8:2), HLA-identical donor cells (25 x 10(7)/kg [median]) were infused after the patients were conditioned with NSC D 245382 (ACNU) or daunorubicin, cyclophosphamide (CY) and a single shot of 1000 rad of TBI. For the second group (ALL/ANLL 4:2, age (median) 20, M/F 5:1), HLA-identical donor cells (22 x 10(7)/kg [median]) were infused after the patients were conditioned with CY and fractionated (250 rad x 4) TBI. All the patients were isolated in a laminar air flow room (LAF) after gut and skin decontamination. Engraftment of donor cells was confirmed in 15 out of the 16 patients. Febrile periods in LAF and the days required for platelet transfusion were prolonged in the first group. All the patients in the first group died within 12-214 days after BMT because of interstitial pneumonitis (7 patients) or bacterial infection (3 patients). On the other hand, five out of six patients in the second group are alive 84-540 days after BMT. For the surviving patients, the complications of chronic graft versus host disease, viral infections, tuberculosis, hepatitis, hemorrhagic cystitis and recurrence of leukemia are now the problems. It can be stated that the patient's clinical condition at the time of BMT is one of the most essential factors for the success of BMT although the effects of other variables, such a change in the conditioning regimens of the supportive care, must also be carefully analyzed.
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PMID:Sixteen adult patients with acute leukemia treated by chemotherapy, total body irradiation and allogeneic marrow transplantation. 639 11

The cellular and humoral components of the neutrophil chemotactic response were studied in 65 children with acute lymphoblastic leukaemia (ALL). An abnormality in both components was found during relapse. In remission the cellular component only was affected. Although less obvious than during relapse the abnormality persisted while all cytotoxic therapy was given, returning to normal several weeks after treatment had been stopped. The absence of significant infection in relapse in this series could be due to the fact that a remisison was achieved within 3 weeks in all patients. However, a positive correlation between the migration index and incidence of bacterial infection during remission stressed the importance of impaired neutrophil chemotaxis in ALL.
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PMID:Neutrophil chemotaxis and random migration in acute lymphoblastic leukaemia of childhood. Cellular and humoral aspects. 693 86

Seventy-four febrile patients with leukaemia or malignant lymphoma, of whom 42 had severe granulocytopenia, were treated with netilmicin in combination with other antibiotics, usually ampicillin and methicillin. Of 36 patients with proven bacterial infection, 72% responded to treatment with complete resolution or improvement. Moderate and reversible renal affection occurred in 10 patients of whom 8 concomitantly were treated with other potentially nephrotoxic drugs. Five of the 10 patients had unintendedly high valley concentrations of netilmicin. Ototoxicity was not documented. It is concluded that netilmicin is an effective and tolerable aminoglycoside.
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PMID:Netilmicin therapy of patients with leukaemia or malignant lymphoma. 693 64


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