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Target Concepts:
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Query: UMLS:C0024312 (
lymphopenia
)
4,859
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The purpose of this study was to characterize varicella in
childhood cancer
patients. Seventeen of the 77 patients reviewed were in remission and off all therapy for 3 to 22 months. No one in this group died from varicella or had evidence of visceral dissemination. Among the remaining 60 patients, all of whom were receiving anticancer theapy when they developed varicella, 19 (32%) had visceral dissemination and 4 died, for a mortality rate of 7%. Each of the deaths was associated with primary varicella pneumonitis, with or without acute encephalitis. Visceral dissemination was not related to type or status of malignancy or to duration of specific anticancer therapy. Varicella was more likely to disseminate in children with absolute
lymphopenia
, less than 500 cells per cubic millimeter, than in patients with higher lymphocyte counts. Cessation of anticancer theapy prior to the onset of lesions appeared to lessen the risk of dissemination. These results show that varicella is more severe in cancer patients on therapy than the general population or in patients who have completed therapy, but is not highly fatal.
...
PMID:Varicella in children with cancer: Seventy-seven cases. 108 28
To estimate the impact of antiviral therapy and prophylaxis on the natural course of the infection, 288 cases of varicella in children with cancer were reviewed. Among 127 patients with untreated infections, the overall mortality rate was 7%. Varicella-zoster virus pneumonitis developed in 28% of the untreated patients and was associated with a 25% mortality rate. Pneumonitis was much more likely to develop in patients with acute leukemia than in those with other malignancies (32% v 19%). Similarly, deaths due to pneumonitis were restricted to patients with acute leukemia.
Lymphopenia
(absolute lymphocyte count less than 500/microL) was significantly associated with varicella-zoster virus pneumonitis and a higher fatality rate among patients with this complication. Both acyclovir and adenine arabinoside, administered to 18 and 28 patients, respectively, stopped the progression of skin lesions; however, pneumonitis developed in none of the acyclovir recipients after two days of treatment, compared with 29% of the adenine arabinoside recipients (P = .03). Passive immunization in 45 children who subsequently had varicella was associated with an 11% incidence of varicella-zoster virus pneumonitis. Despite passive immunization of approximately 150 children, the attack rate of varicella at our institution remains unchanged. Results of this study demonstrate the efficacy of antiviral therapy and passive immunization in patients with
childhood cancer
and varicella, but prevention of the infection will require a universal vaccine.
...
PMID:Varicella in children with cancer: impact of antiviral therapy and prophylaxis. 282 76
Pediatric cancer patients treated with multimodal therapy are at a great risk of opportunistic infections or reactivation of latent infections. Human herpesvirus-6 (HHV-6) can serve as an example of such infection, with high seroprevalence in population. In 66 children with cancer and in 45 healthy controls, age matched, the presence of DNA HHV-6 was examined in peripheral blood by the polymerase chain reaction method. HHV-6 serology was also performed. No difference has been found between patients at the time of cancer diagnosis and the group of healthy children in the presence of DNA HHV-6 in blood, 17.4 and 15.6%, respectively. During cytotoxic chemotherapy the presence of HHV-6 in peripheral blood raised to 37.1% in patients with fever. Other parameters and symptoms such as febrile neutropenia,
lymphopenia
, exanthem, hepatopathy, lymphadenopathy, enteritis, bone marrow aplasia, pneumonitis, and encephalitis were examined in both the HHV-6 positive and HHV-6 negative groups of
pediatric cancer
patients. Statistically significant differences (p < .05) were found in case of
lymphopenia
, exanthem, and hepatopathy. In 4 out of 66 patients (6.1%) severe HHV-6 infection has been found: in 3 patients during cytotoxic chemotherapy and in 1 at the time of cancer diagnosis. Reactivation of HHV-6 infection in
pediatric cancer
patients under treatment with cytotoxic chemotherapy is frequent and can lead to severe complications as described in patients after bone marrow or organ transplantation.
...
PMID:Human herpesvirus-6 infection in children with cancer. 1050 18
Atypical mycobacteria are seen more frequently as a cause of serious infection in children with cancer. Thirteen
pediatric cancer
patients with blood or tissue cultures positive for atypical mycobacteria were identified by review of records over a 5-year period at one center. All had central venous catheters and were lymphopenic at the time of infection. Eleven children had rapidly growing mycobacteria and two children had M. avium-intracellulare. Nine patients had positive blood cultures. Three were treated with catheter removal as sole therapy, five had catheter removal plus antibiotics, and one had antibiotics alone. Two patients with pulmonary M. avium-intracellulare infection received antibiotic therapy alone. It is concluded that infection with rapidly growing mycobacteria in children with cancer is associated with presence of a central venous catheter and
lymphopenia
. Some children with uncomplicated catheter-associated infection with rapidly growing mycobacteria may be sufficiently treated with removal of the catheter alone.
...
PMID:Atypical mycobacterial infections in children with cancer. 1539 Mar 14