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

Clinical and pathological analysis were performed on 127 cases of deep mycoses diagnosed by autopsy during the 24 years between 1964 and 1987 in Juntendo University Hospital. The following findings were obtained. 1) There has been a tendency for the number of mycoses to increase each year, especially notable for candidiasis and aspergillosis. 2) Underlying diseases were, in order of incidence, various hematologic diseases, solid tumors, inflammatory diseases and collagen diseases; the most common were various types of leukemia. 3) Candidiasis was often observed in patients with gastrointestinal tract cancers. Aspergillosis was often observed in patients with collagen diseases. 4) Regarding the visceral distribution of mycoses, aspergillosis was observed in the lung, candidiasis was observed in the lung, kidney and intestinal tract in decreasing order, and cryptococcosis was also observed in the lung and central nervous system. 5) There was a probability of fungal infections occurring in cases of lymphopenia. 6) A fever was present at the time of hospitalization in many cases of aspergillosis, and the presence of an indwelling catheter was a common feature in cases of candidiasis. 7) Fungemia was frequently observed in candidiasis, but very rarely in cases of aspergillosis. 8) The large amounts of corticosteroid hormones and blood transfusions were suspected as causative factors of fungal infections.
 ...
PMID:[Clinical and pathological analysis of deep mycoses]. 206 3

During a period of 32 months (August 1986 until April 1989) 108 patients (74 women, 34 men; mean age 53 years) with neoplastic diseases (59 patients with solid tumors, 45 patients with lymphomas, two patients with acute leukaemias, one patient with chronic myelogenous leukaemia, one patient with aplastic anaemia) were studied in the Department of Internal Medicine of the University Erlangen-Nuremberg. Most were treated with a cytostatic chemotherapy. In order to prevent a mycotic infection in these immunocompromised patients, itraconazole, a new broad-spectrum antimycotic drug of the azole group, was given in an oral dosage of 100 mg day-1 (mean duration of prophylactic treatment 24 months). Localized Candida infections involving the oropharynx and the female genital organs were diagnosed in 16 patients (14.8%). Candida endophthalmitis occurred in one patient (0.9%). The serum concentration of Candida antibodies was significantly elevated in one patient (0.9%) without evidence of fungemia. Itraconazole had to be discontinued in four cases (3.7%) due to minor side effects of the drug (nausea, stomach complaints). Itraconazole appears to be a safe and effective antimycotic drug in long-term use in neutropenic patients.
 ...
PMID:Prophylaxis of fungal infections with itraconazole in immunocompromised cancer patients. 217 92

In an effort to search for new, synergistic and non-cross-resistant antileukemic regimens, the Cancer and Leukemia Group B (CALGB) investigated the activity and toxicity of mitoxantrone in combination with etoposide for the reinduction of patients with relapsed or refractory acute myelocytic leukemia (AML). Mitoxantrone, 12 mg/m2 daily for 3 days, was combined with three dose levels of etoposide, 100, 150 and 200 mg/m2 daily by constant infusion for 5 days. There were 19 male and 13 female patients, with a median age of 46 (range, 21-74). Of these, nine were primarily refractory to daunorubicin and ara-C; 17 had one prior complete remission (CR), five had two prior CR, and one had three prior CR. Thirteen patients were entered at the first dose level, 11 were entered at the second, and eight at the third. All but one patient, whose death occurred within the first 2 days of treatment, are evaluable for toxicity. There were five CR (four at the first and one at the second dose level) and six partial remissions (PR) (three at the first dose level and three at the second). Unmaintained responses lasted 6-33 weeks. Median survival for all patients was 12.6 weeks. Anti-leukemic effects with severe marrow hypoplasia were observed in all patients; severe nausea and vomiting were seen in four. Severe mucositis, often indistinguishable from superimposed candidiasis, occurred in 40% of all patients; it was associated with dose-limiting esophagitis (three of seven evaluable patients) at the highest etoposide dose. Hepatic and renal dysfunction was severe in three patients; no treatment-related severe pulmonary or cardiac toxicity was observed. Posttreatment infectious complications were severe in 11 patients. In three cases, they were fatal--an incidence not dissimilar from that of other reinduction regimens in heavily pretreated patients. The regimen appears to be active; the combination of mitoxantrone, 12 mg/m2 daily for 3 days, with etoposide, 150 mg/m2/day for 5 days, by constant intravenous infusion is now being explored by the CALGB in a randomized phase II study against mitoxantrone plus diazoquinone and diazoquinone plus etoposide.
 ...
PMID:Mitoxantrone and constant infusion etoposide for relapsed and refractory acute myelocytic leukemia. 223 6

In a review of 61 consecutive autopsy cases with a hematologic malignancy, said cases extending from April, 1984 to August, 1989, 34 cases were documented to have had an invasive fungal infection. The highest rate of incidence was found in various leukemia cases (69 to 100%), followed by those who had had a malignant lymphoma (50%) and a multiple myeloma (33%). Cultures from autopsy materials that determined the presence of a fungus were positive in 21 cases, including 13 cases of candidiasis, 8 cases of aspergillosis, and 2 cases of geotrichosis. The most frequent site of the fungal infection was in the lungs (76%), followed by the GI tract, the kidneys, the liver, and the spleen. Of 36 cases that had been treated with an empiric antifungal therapy, an invasive fungal infection was documented in 22 cases, half of them being fatal. In contrast, of 20 cases that had not received any antifungal treatment prior to death, an invasive fungal infection was found in 8 cases and three of these were fatal.
 ...
PMID:[Invasive fungal infections in hematologic malignancies--a retrospective study of 61 autopsied cases]. 236 25

Disseminated candidiasis is the most common fungal infection occurring in patients with hematologic malignancies. Unless rapidly diagnosed and treated, it is usually fatal. The signs and symptoms of disseminated candidiasis are nonspecific but sometimes include a skin eruption of papulonodules with pale centers. Biopsy or culture of skin lesions does not usually allow prompt diagnosis. We describe two patients with leukemia with disseminated candidiasis in whom the diagnosis was rapidly made by a potassium hydroxide preparation and a Gram's stain of a touch preparation of the punch biopsy specimen.
 ...
PMID:Use of touch preparation for rapid diagnosis of disseminated candidiasis. 246 76

In patients with acute leukaemia, Candida infection may affect exclusively the liver and the spleen. Two such cases were revealed by persistent fever despite correction of bone marrow aplasia, abdominal pain, anicteric cholestasis and hypodense areas at computerized tomography suggesting hepatosplenic abscesses. Surgical liver biopsy confirmed the fungal infection and showed images of granuloma, mycelial filaments and yeasts; cultures were usually negative. The severity of these infections requires an early treatment, but amphotericin B is not very effective. Our two patients were cured after treatment with fluoconazole completed, in one of them by splenectomy.
 ...
PMID:[Hepato-splenic candidiasis in patients treated for leukemia]. 253 56

The clinical efficacy of fluconazole at doses of 100-400 mg daily given intravenously in the treatment of 6 cases of deep mycosis complicated with leukemia was evaluated. Types of leukemia as underlying disease were acute lymphatic leukemia in 4 patients (included post bone marrow transplantation in 2 patients), acute myelocytic leukemia in 1 and acute myelomonocytic leukemia (AMMoL) in 1. Causative fungi were Candida in all patients. Diagnoses established were pulmonary or bronchial candidiasis in 3 patients, candiduria in 2 and suspected candidemia accompanied with stomatitis in 1. A patient with candiduria died from AMMoL thus the evaluation of efficacy was made with 5 patients. Overall clinical efficacies were judged to be good in 3 cases of pulmonary or bronchial candidiasis and in 1 case of suspected candidemia accompanied with stomatitis and excellent in 1 case of candiduria with an efficacy rate of 100%. No side effect, either subjective or objective, was reported with any patient. In clinical laboratory tests, elevations of serum transaminase and Al-P were observed in 2 patients and a rise of S-Cr. in 1, but all these abnormalities were judged to be related to the drugs for leukemia treatment.
 ...
PMID:[Clinical evaluation of fluconazole in the case of deep mycosis associated with leukemia]. 254 Mar 57

A multicenter clinical study of fluconazole was conducted at 41 hospital sites in Japan. Fluconazole was administered orally or intravenously at daily doses of 50 to 400 mg to 199 patients with deep-seated mycoses. Clinical efficacy was evaluable in 125 of these patients. Most cases were complicated with serious underlying diseases such as cancer, leukemia, or AIDS. Clinical cures were achieved in 56 (87.5%) of 64 cases of candidiasis, in 11 (68.8%) of 16 cases of cryptococcosis, in 19 (44.2%) of 43 cases of aspergillosis, and in one case each (100%) of mucormycosis and fungemia due to an unspecified yeast. Eradication rates of causative fungi were 87.9% in Candida spp., 62.5% in Cryptococcus neoformans, and 52.2% in Aspergillus spp. Side effects were observed in 13 cases, with an incidence rate of 6.5%. In most cases fluconazole was well tolerated. Changes in laboratory test values due to the drug were reported in 35 patients with an incidence rate of 17.6%. The changes were minor and transient; primarily increases in liver enzyme. Fluconazole is a useful antifungal agent for the treatment of systemic deep-seated mycoses.
 ...
PMID:A clinical study of fluconazole for the treatment of deep mycoses. 255 41

About half of the general population harbors Candida species in oral flora, and oral candidal infections are common. However, in immunocompromised or immunosuppressed patients, candidiasis may progress to life-threatening systemic disease. Patients with human immunodeficiency virus (HIV), acquired immunodeficiency syndrome, HIV disease, diabetes, or leukemia are particularly prone to serious systemic infection. Chemotherapy for cancer and bone marrow and organ transplantation also provide physiologic opportunities for candidal colonization. Topical therapy has the potential to prevent and treat candidiasis with less risk of side effects and drug interactions than systemic therapy. Among the effective topical agents are polyene antifungal antibiotics and imidazole compounds. Some of these agents have been found useful in prevention of serious candidal infection in high-risk patients; however, more study is needed in this area.
 ...
PMID:Oral and pharyngeal candidiasis. Topical agents for management and prevention. 264 72

Four immune-compromised children who were receiving antineoplastic chemotherapy (three for leukemia), presented with recurrent episodes of fever and left upper abdominal pain. Blood cultures grew enteric gram-negative organisms in three children. Multiple blood cultures were negative for fungus although three patients had mucocutaneous and urinary candidiasis. All remained febrile and symptomatic despite treatment with broad spectrum antibiotics and antifungal chemotherapy. Computed tomography (CT) scans in all patients showed 2- to 10-mm focal defects in the spleen. The larger defects could be seen by ultrasonography but not on the live-spleen nuclear scan. A splenectomy was performed 2 to 4 weeks after the onset of symptoms in each child, and the cut surface of the spleens showed multiple small abscesses. All operative cultures were negative. A histological examination confirmed Candida infection in two patients and Aspergillus in one. Necrotizing granulomas strongly suggestive of fungus were seen in the fourth child. The patients defervesced and appeared well within three days. Antifungal therapy was continued. One child remains in remission from acute lymphocytic leukemia; one continues on chemotherapy; and one has recurrent widespread tumor. The patient with Aspergillus died following a bone marrow transplantation 6 months after the splenectomy. He had disseminated aspergillosis. An immune-compromised patient with persistent unexplained fever should have a CT scan of the abdomen. The presence of multiple splenic lesions strongly suggests fungal disease. If antifungal therapy does not result in complete resolution of fever and the splenic lesions, a splenectomy is indicated.
 ...
PMID:Splenic microabscesses in the immune-compromised patient. 275 88


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>