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Query: UMLS:C0023418 (leukemia)
 93,477 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical charts of cancer patients with documented fungal infections hospitalized at G. Gaslini Children's Hospital, Italy, from 1980 to 1990 were reviewed. Thirty-seven episodes developing in 37 patients were identified, based on microbiological and/or histological documentation. Patients' age ranged from 3 months to 18 years (median 7 years). Twenty patients were treated for hematological malignancy and 17 had solid tumor. Seven patients (3 with leukemia and 4 with solid tumours), developed mycosis after bone marrow transplantation procedure. A history of neutropenia in the month preceding the documentation of fungal infection was present in 76% of cases (28 of 37). However, only 16 of 28 (55%) of these patients were still neutropenic at time of diagnosis. In 40% of the cases the fungal infection developed as primary infection not preceded by any febrile and/or infectious episode. Fungemias without evident organ localization accounted for the 40% of episodes with a mortality rate of 20%. The other 22 cases (60%) were classified as invasive mycoses; 9 of these patients died (41%). Mortality was higher among patients with mold infection (5 of 7, 72%), than in those with yeast infection (7 of 29.24%). Molds infections and invasive mycoses were virtually absent in the first part of our period of observation (1980-84), but emerged in the second period (1985-90) when also the incidence rate of fungal disease increased (from 2.67/10,000 person/day to 5.93), probably in relation with extensive construction works and with the implementation of a bone marrow transplantation program.
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PMID:[Fungal infections in pediatric oncology]. 868

Infections with fluconazole-resistant Candida albicans isolate have rarely been described in clinical settings other than oropharyngeal candidiasis in patients with late-stage AIDS. We report on two patients with leukemia who developed fungemia caused by fluconazole-resistant C. albicans after receiving fluconazole prophylaxis (400 mg/day) and empiric amphotericin B therapy (0.5 mg/kg of body weight per day). The fluconazole MICs for the isolates were > or = 64 micrograms/ml, and the isolates were resistant to other azoles and had membrane sterol changes consistent with a mutation in the delta 5,6-sterol desaturase gene. The lack of ergosterol in the cytoplasmic membrane of the fluconazole-resistant strains also imparted resistance to amphotericin B. Both patients were successfully treated with high-dose amphotericin B (1 to 1.25 mg/kg/day) and flucytosine (150 mg/kg/day).
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PMID:Isolation and characterization of fluconazole- and amphotericin B-resistant Candida albicans from blood of two patients with leukemia. 898 Jul 81

The authors studied a relationship between particular bacterial or fungal organisms isolated from blood cultures and type of malignancy and antineoplastic drugs in 237 cancer patients. Sixty four had acute myelogenous leukemia (AML), 43 non-Hodgkin's lymphoma (NHL) and 140 solid tumors (ST). All patients had at least one positive blood cultures for one or more microorganism drawn during 1-10 days after cytotoxic chemotherapy, viridans streptococcal bacteremia was more frequently observed in patients with AML (12.5%) and NHL (27.9%) than ST (43%, p < 0.01 and 0.03). The incidence of anaerobic bacteria was similar in patients with NHL and ST, and in both groups significantly higher (p < 0.05) than in AML. Enterobacteriaceae caused bacteremia less frequently in patients with AML than in those with ST (12.5 vs 27.8%, p < 0.05). However, the highest incidence of Stenotrophomonas maltophilia bacteremia was seen in patients with AML (6.3% vs 2.3%, p < 0.04 and 0.03). Concerning fungemia, Candida albicans occurred significantly more frequently in blood cultures in patients with NHL, and molds in patients with AML. Cytarabine and metothrexate seems to be more frequently associated with viridans streptococci, cytarabine and mitoxanthrone with Stenotrophomonas maltophilia, B. fragilis with cisplatin and 5-fluorouracil, Fusarium spp., Mucorales and Aspergillus spp. with acute leukaemia (AL) treated with cytarabine and mitoxantrone. The association of other pathogens with an underlying disease or chemotherapeutic regimen could not be documented. (Tab. 1, Ref. 19.).
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PMID:Etiology of bacteraemia in patients with various malignancies: is there association between certain antineoplastic drugs and microorganism? 911 32

We report two cases of Fusarium infection with evidence of fungaemia in severely neutropenic patients with leukaemia. One patient was a 65-year-old woman with chronic lymphocytic leukaemia infected by Fusarium verticillioides. The other patient was a 45-year-old woman with acute myeloblastic leukaemia infected by Fusarium spp. Fungaemia was the only evident manifestation of these fungal infections.
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PMID:Fusarium fungaemia in severely neutropenic patients. 991 88

A prospective analysis of 43 episodes of Pseudomonas aeruginosa bacteremia in HIV-1-infected subjects was performed and the results compared with the incidence and outcome of Pseudomonas aeruginosa bacteremia in other high-risk patients, such as transplant recipients, leukemia patients, or patients hospitalized in the intensive care unit. The incidence of bacteremia/fungemia as a whole and of gram-negative and Pseudomonas aeruginosa bacteremia in particular was greater in HIV-1-infected subjects than in the unselected general population admitted. In contrast, the incidence of Pseudomonas aeruginosa bacteremia in HIV-1-infected patients did not differ from that in patients with other high-risk conditions. In patients with HIV-1 infection, independent risk factors for presenting Pseudomonas aeruginosa bacteremia were nosocomial origin (OR, 2.7; 95% CI, 1.3-5.7), neutropenia (OR, 2.7; 95% CI, 1.07-6.8), previous treatment with cephalosporins (OR, 3.6; 95% CI, 1.1-11.6), and a CD4+ cell count lower than 50 cells/mm3 (OR, 3.1; 95% CI, 1.7-8.6). Primary bacteremia and pneumonia were the most common forms of presentation. Fourteen (33%) patients died as a consequence of the bacteremia. The presence of severe sepsis (OR, 17.5; 95% CI, 3.2-68) and the institution of inappropriate definitive antibiotic therapy (OR, 2.7; 95% CI, 1.1-13) were independently associated with a poor outcome. One year after the development of bacteremia, only eight (19%) patients remained alive.
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PMID:Pseudomonas aeruginosa bacteremia in patients infected with human immunodeficiency virus type 1. 1048 23

The Japan Adult Leukemia Study Group analyzed infectious episodes in 577 patients with acute myeloid leukemia during remission induction therapy between 1987 and 1991. 542 patients (93.9%) experienced at least one infectious episode, 121 (21.0%) had microbiologically documented infection; there was clinically documented infection in 184 (31.9%) and unexplained fever in 237 (41.1%). Among 121 microbiologically documented infections, bacteremia/fungemia was observed in 68, pneumonia in 33, and other types of infections in 20. Among the bacteremia/fungemia, gram-negative bacteria accounted for 41.2% (Pseudomonas aeruginosa was the most common), gram-positive bacteria for 39.7%, fungi for 16.2% (Candida spp. being most frequent), and polymicrobial for 2.9%. The most frequent isolates among pneumonia were Pseudomonas aeruginosa and Aspergillus. A total of 70 patients (12.1%) died during remission induction. Mortality of 68 patients with bacteremia/fungemia was 26.5%; in these patients, mortality with concomitant pneumonia increased to 41.4%; without pneumonia, mortality was 15.4% (P < 0.05). Mortality according to the isolated microbes was 17.2% for gram-negative bacteria, 25% for gram-positive bacteria, and 54.5% for fungi. Mortality of 113 patients with pneumonia (33 microbiologically documented and 80 clinically documented), 20 with other microbiologically documented infections, 104 with other clinically documented infections, and 237 with unexplained fever was 25.7%, 5.0%, 5.8%, and 5.1%, respectively.
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PMID:Infectious complications during remission induction therapy in 577 patients with acute myeloid leukemia in the Japan Adult Leukemia Study Group studies between 1987 and 1991. 1064 52

The risk factors for and presentation of Candida tropicalis fungemia, in comparison with those of Candida albicans, have been incompletely characterized. We compared 43 cases of C. tropicalis fungemia with 148 cases of C. albicans fungemia. In univariate analysis, patients with C. tropicalis fungemia were more likely to have leukemia (P=.0006), prolonged neutropenia (P=.03), and a positive blood culture for more days (P=.02). The 2 groups did not differ with regard to baseline Acute Physiology and Chronic Health Evaluation (APACHE) II score, frequency of catheter-associated fungemia, or response to antifungals. In multivariate analysis, patients with C. tropicalis fungemia were more likely to have leukemia (P=.02), previous neutropenia (P=.002), and a longer stay in the intensive care unit during the infectious episode (P=.01). Also, the response of the breakthrough C. tropicalis fungemia was lower (P=.05). In conclusion, the host determinants associated with susceptibility to C. tropicalis are leukemia and prolonged neutropenia.
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PMID:Risk Factors for Candida tropicalis fungemia in patients with cancer. 1156 58

We report the case of a young man with a resistant acute myeloid leukemia (AML) who developed a disseminated fungemia due to Fusarium solani involving the skin and lungs, during the neutropenic phase following a chemotherapy course. Despite continuous therapy with liposomal amphotericin B, he developed a bilateral endophthalmitis that rapidly evolved to complete blindness. The patient underwent two procedures of vitrectomy, with detection of F. solani in the vitreous fluid, and continued antifungal therapy, without any recovery of visual acuity. When he eventually died due to recurrence of leukemia and hemorrhagic shock, autopsy revealed a diffuse fusarial involvement of the central nervous system.
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PMID:Endogenous endophthalmitis following disseminated fungemia due to Fusarium solani in a patient with acute myeloid leukemia. 1214 39

This study is a retrospective investigation to determine the species of yeasts causing fungemia in a university hospital in Saudi Arabia during the years 1991-2000. A total of 189 episodes of fungemia were encountered, of which 121 (64%) occurred during 1991-1995, whereas only 68 cases (36%) were found between 1996 and 2000. Overall, 50.3% episodes were due to Candida albicans including five episodes of C. dubliniensis, followed by C. tropicalis (27%), C. parapsilosis (7.9%), C. glabrata (7.4%), C. krusei (3.2%), C. famata (1.0%); 3.2% were due to other species, namely Blastoschizomyces capitatus, Hansenula anomala, Rhodotorula rubra, and Trichosporon beigelii. The percentage of episodes of fungemia caused by C. albicans ranged from 36.4% in 1991 to 71.4% in 2000, revealing an increase in recent years. The incidence of non-C. albicans fungemia decreased from 63 (33.3%) during the first 5 years (1991-1995) to 31 (16.4%) episodes during the second 5 years. Moreover, no fungemia due to C. glabrata and C. krusei were observed during the last 3 years. Overall, during the years of the study, a decreasing incidence of yeast fungemia was observed. Fungemia occurred more frequently in patients with leukemia (24%), prematurity (16%), postsurgery (10.6%), and lymphoma (9.5%). Patients with respiratory infections and preterm infants more often had C. albicans fungemia, whereas C. tropicalis predominated in patients with hepatic disorders and leukemia. The study reports for the first time the involvement of C. dubliniensis in yeast fungemia occurring in Saudi Arabia.
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PMID:The yeast species causing fungemia at a university hospital in Riyadh, Saudi Arabia, during a 10-year period. 1295 Aug 97

A 14-year-old boy who was neutropenic following chemotherapy for leukemia developed fungemia caused by the yeast Kodomaea ohmeri ( Pichia ohmeri). The infection was cured by catheter removal and the use of fluconazole. A 74-year-old man who had undergone surgeries for a subcutaneous tumor developed polymicrobic cellulitis involving Kodomaea ohmeri. Despite surgical debridement and antibiotic therapy, the patient died of complications. Including these 2 cases, there have been 10 Kodomaea ohmeri infections reported thus far, all occurring in patients with pre-existing conditions. There have been seven cases of fungemia and one case each of peritonitis, funguria, and cellulitis. The treatment employed varied depending on the site/source of infection. Seven patients recovered and three died. The microbiological data available suggest that Kodomaea ohmeri can be identified definitively by biochemical tests and is susceptible to amphotericin B and either susceptible to or dose dependently susceptible to itraconazole and fluconazole.
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PMID:Infections by the yeast Kodomaea (Pichia) ohmeri: two cases and literature review. 1472 84


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