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)

Out of 38 leukaemic cases only 16 had extensive leukaemic infiltration at death. 15 patients had slight or moderate and 7 no infiltration at all. 12 of the 15, and 5 of the 7 died with septicaemia. The latter patients must have died of complications rather than of the leukaemia itself. Although it has been possible to reduce the incidence of septicaemia during life, terminal septicaemia does not yet seem to be preventable. Septicaemia was revealed at autopsy in 27 of 38 patients; 25 of these also had clinical signs of septicaemia before death. Necrotizing gastrointestinal lesions may cause endogenous infection. In the present material, almost every second patient had fungal septicaemia. Out of 7 patients having oral candidiasis in vivo 5 had systemic candidiasis at autopsy, but only half of the patients with systemic candidiasis had visible oral growth. Modern treatment of leukaemia seems to be able to prevent intracranial haemorrhage in 90% of the cases. On the other hand, vacuolization of muscle and liver tissue was a frequent finding in leukaemia. It is suggested as being caused by fatty degeneration. Vacuolization of myocardial cells was found in 7 out of 13 cases. Among these 7, 4 had had intermittent hypokalaemia.
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PMID:Autopsy findings in leukaemia. 99 42

Cardiac pathologic findings were analyzed in 22 necropsy cases from a series of 29 patients with leukemia, aplastic anemia, or metastatic cancer who had been treated with ablative therapy followed by bone marrow transplantation. Some cardiac alterations were similar to those that occur in patients with hematologic and neoplastic diseases not treated with bone marrow transplantation, and consisted of cardiomegaly, cardiac atrophy, hemorrhage, foci of necrosis due to shock associated with sepsis or hepatic failure, myocardial abscesses secondary to systemic candidiasis or staphylococcal infection, fibrinous pericarditis, and hemosiderosis. Other cardiac alterations were more specifically related to factors associated with transplantation procedure. Six patients exhibited a distinctive interstitial reactive change characterized by the presence of (1) moderate to large numbers of Anitschkow cells, occurring alone or in small cellular aggregates and histiocytes, histiocytic cells with nuclei of the Anitschkow type, lymphoid cells, and plasma cells, and (2) nuclei of the Anitschkow type in cardiac vascular and endocardial smooth muscle, endothelial and Schwann cells, and occasional cardiac muscle cells. This alteration may have been induced by abnormal immune mechanisms, as suggested by the observation that five of the six patients with interstitial change had clinical evidence of graft-versus-host disease. Two patients developed fatal congestive cardiac failure in the early post-transplant period and exhibited myocardial damage with histologic and post-transplant period features indicative of severe acute injury. Findings in these two patients consisted of necrotic muscle cells, which exhibited multiple contraction bands, diastase-resistant PAS staining, and intracellular fibrin deposits; microthrombi, which were composed of fibrin and occasionally of fibrin and platelets; and extravasated erythrocytes and fibrin strands in the interstitium. One of the two patients also exhibited unusual nuclear alterations, which were characterized by replacement of normal chromatin by palely stained fibrous and filamentous material. Clinicopathologic analysis strongly suggested that the fatal cardiotoxicity in both patients resulted primarily from effects of high doses of cyclophosphamide, which were administered as part of a four drug regimen that provided tumor ablation and immunosuppression for bone marrow transplantation. Our findings emphasize the need for less toxic antineoplastic and immunosuppressive therapy for use in bone marrow transplantation procedures.
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PMID:Cardiac pathologic findings in patients treated with bone marrow transplantation. 110 69

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.
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PMID:Use of touch preparation for rapid diagnosis of disseminated candidiasis. 246 76

Fourteen patients with the diagnosis of leukemia and one with lymphoma developed systemic candidiasis. Involvement of the liver (15 patients), spleen (nine patients), and kidney (five patients) was diagnosed by clinical, CT, and pathologic findings. The CT findings ranged from low-density lesions (11 livers, nine spleens, and five kidneys) to hepatomegaly or hepatosplenomegaly. All livers and three kidneys had positive biopsy findings for Candida. Two patients with diffuse splenic lesions underwent splenectomy and were proven to have candidiasis. During a 1 year follow-up, two patients developed hepatic calcifications and one developed renal calcifications. In proper clinical setting, CT should be done for simultaneous evaluation of the liver, spleen, and kidneys. These studies, when positive, are useful to guide percutaneous or open biopsy and to follow the results of therapy. However, regardless of the hepatic CT finding, biopsy should be obtained to establish the diagnosis and begin proper treatment.
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PMID:CT findings in hepatosplenic and renal candidiasis. 330 88

Four cases of Malassezia folliculitis in immuno-compromised patients with leukemia, papillary adenocarcinoma of the lung, and chronic renal failure are reported. This condition manifests with multiple bland asymptomatic follicular papules of the trunk and arms. Biopsy specimens show dilated follicles containing unipolar budding yeast forms. Malassezia is a common infection that must be differentiated from the cutaneous manifestations of systemic candidiasis.
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PMID:Malassezia folliculitis in immunocompromised patients. 401 48

Three patients are described who developed systemic candidiasis. Each had either leukaemia or lymphoma, and developed a similar erythematous maculopapular rash which, in places, was purpuric. In the first patient the nature of the rash was not appreciated during life, but postmortem histology revealed candida within the lesions. In the other two patients, a diagnosis of systemic candidiasis was successfully established by skin biopsy. This paper emphasizes that a maculopapular rash can be relatively characteristic clinical manifestation of systemic candidiasis and that skin biopsy can be diagnostic.
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PMID:Systemic candidiasis: diagnosis from cutaneous manifestations. 714 38

Skin lesions in systemic candidiasis are erythematous maculopapules and maculonodules which appear at the onset of the septicaemic phase. Their presence, especially when associated with diffuse myalgia, suggest the diagnosis which must be confirmed by haemocultures, histological examination of the skin with PAS stain and culture of skin fragments in Sabouraud's medium. Systemic candidiasis with skin lesions seems to be mainly due to Candida tropicalis and to occur with great frequency in patients with underlying blood disease. Of the three cases reported here, one concerned a 24-year-old man with premyelocytic acute leukaemia, the second a 45-year-old woman with drug-induced agranulocytosis and the third one a man aged 25 admitted to hospital for peritonitis secondary to Crohn's disease.
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PMID:[Skin lesions in systemic candidiasis (author's transl)]. 723 70

Much progress has been made over the last decade in diagnosing and treating CDC, a chronic and debilitating infection that interferes with the delivery of intensive cytotoxic chemotherapy in patients with leukemia. The use of fluconazole prophylaxis in these patients has decreased the incidence of CDC dramatically. The greatest future challenges are gaining a better understanding of its pathophysiology, and the continued development of effective diagnostic and therapeutic strategies to treat this unusual manifestation of systemic candidiasis.
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PMID:Hepatosplenic candidiasis. A manifestation of chronic disseminated candidiasis. 1098 17

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality in neutropenic patients with leukemia and those undergoing hematopoietic stem cell transplant (HSCT). Two major IFIs are systemic candidiasis (including candidemia, chronic disseminated candidiasis and pneumonia) and invasive pulmonary aspergillosis. Recently, the incidence of the latter has been increasing. Three levels of diagnosis are specified in the Japanese guidelines for the diagnosis and treatment of IFIs. Proven fungal infections are diagnosed by histological/microbiological evidence of fungi at the site of infection or positive blood culture (fungemia). Clinically documented fungal infections are diagnosed by typical radiological findings such as halo sign on chest CT plus positive serological/molecular evidence of fungi such as Aspergillus galactomannan, beta-glucan or fungal DNA. Possible fungal infections are diagnosed by typical radiological findings or positive serological/molecular evidence of fungi. For patients with high risk such as those undergoing HSCT, antifungal prophylaxis using oral antifungal agents is recommended. For possible fungal infections, empiric therapy with fluconazole (FLCZ) or amphotericin B (AMPH) is recommended. For patients with proven fungal infections or clinically documented fungal infections, targeted therapy is warranted. In case of candidemia, the best choice is FLCZ (400 mg/day) or AMPH (0.5-0.7 mg/kg/day), and for invasive pulmonary aspergillosis, a higher dose of AMPH (1.0-1.5 mg/kg/day) is indicated. Micafungin (MCFG), recently licensed in Japan, is an active agent for both Candida and Aspergillus. This drug seems useful for empiric and targeted therapy of IFIs.
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PMID:[Guidelines for the management of deep mycosis in neutropenic patients]. 1555 Sep 17