Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

VP-16-213, a semisynthetic podophyliotoxin, was tested for antitumor and clinical toxicity in 126 children. The drug was administered iv daily x 5 days every 2 weeks at a starting dose of 75 mg/m2/day. The dose was increased by 25 mg/m2/day/course until clinical response or significant toxicity occurred. The only major toxicity was hematologic, with neutropenia as the most predominant feature. There was one local allergic reaction at the site of injection. No systemic allergic responses were reported. The drug demonstrated significant activity in acute myelomonocytic leukemia with four responses among 19 patients, less activity in acute myelocytic leukemia with two responses among 44 patients, and little activity in acute lymphocytic leukemia with only one partial response among 12 patients. Objective partial responses occurred in ten of 48 patients with solid tumors: two each with Wilms' tumor, lymphoma, and histiocytosis X, and one each with rhabdomyosarcoma, neuroblastoma, Ewing's sarcoma, and undifferentiated carcinoma. The inclusion of VP-16-213 in combination chemotherapy for childhood acute myelomonocytic leukemia and acute myelocytic leukemia appears indicated in patients relapsing after initial therapy. For solid tumors this is an interim report, with further patient accrual required before specific comments can be made.
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PMID:Phase II study of VP-16-213 in childhood malignant disease: a Children's Cancer Study Group Report. 29 6

Pulmonary infiltrates associated with fever are frequently encountered in patients with acute leukemia or lymphoma; In this prospective series, we analyze 47 such episodes in 43 patients. Overall mortality was 45 per cent in patients with infiltrates and somewhat higher when they also had neutropenia (55 per cent) or acute leukemia (67 per cent). Pulmonary infiltrates could be categorized into three roentgenographic patterns: local consolidation (55 per cent); cavitary disease (13 per cent) and diffuse interstitial disease (32 percent). The exact etiology of the infiltrates could not be predicted by roentgenographic study. Microbiologic or histopathologic diagnosis was established during life in 57 per cent of the patients, with infection most commonly encountered. Twenty-one patients underwent lung biopsy procedures. Biopsy specimens were frequently diagnostic (n = 17) and often dictated therapeutic changes (n = 12). Transbronchial lung biopsy via the fiberoptic bronchoscope was utilized in 14 patients during the latter part of this study; diagnoses were obtained in nine patients. Morbidity was minimal with this procedure, and the need for thoracotomy was diminished when it was available.
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PMID:Pulmonary infiltrates and fever in patients with hematologic malignancy: assessment of transbronchial biopsy. 30 May 66

Neutrophil antigens may be classified into two major categories: antigens shared with other cells and antigens specific for neutrophils. The first category includes the ABH, I, i, 5a,b and HLA determinants. Additional antigens with special characteristics in this category are the blood-group U, Kx, JkaJkb, and Ge determinants which apparently neutrophils share only with erythrocytes. Neutrophil-specific antigens include the NA1, NA2, NB1 and 9a. These specificities are detected by the agglutination test and have been shown to be present on mature neutrophils. Independent allospecificities, detectable by the granulocytotoxicity test, may also exist. In addition, neutrophil antigens, which are species-specific, have been identified by the use of xenogeneic antibodies. The EDTA-dependent agglutination test remains a most reliable assay for the study of neutrophil-specific antigens. The lack of reproducibility known in the leukoagglutination reaction does not pertain to the modification used in the assay of neutrophil-specific antibodies. It does apply, however, to those tests that were performed in the absence of EDTA, and in connection to the study of HLA-related antigens. For every pathophysiological state involving the erythrocyte antigens a neutrophil analogue is observed, the difference being in symptomatology which is related to the structural and functional characteristics of the cells: febrile and pulmonary transfusion reactions result from incompatibility neutrophils. It is found that similarity in the HLA antigens and nonreactivity in the MLC test do not preclude immunization against neutrophil-specific antigens. Therefore, it is probable that febrile and pulmonary reactions will occur in the recipients of multiple granulocyte transfusions, even though donors and recipients may be considered "histocompatible" by the HLA assays. It has been shown that fetal-maternal incompatibility can cause neonatal neutropenia, and several forms of autoimmune neutropenia are described: in "idiopathic" neutropenia of infancy, autoantibodies have been found to have specificity against NA1 and NA2 and in one adult, autoimmune neutropenia due to anti-NA1 antibody has been observed. Neutropenia also occurs due to idiopathic, cold-reacting antileukocyte antibodies, and with cold agglutinins associated with lymphoma, infectious mononucleosis, and Mycoplasma pneumonia. Although the role of neutrophil antigens in bone marrow transplantation has not as yet been determined, these antigens are undoubtedly immunogenic and potentially play an important role in neutrophil compatibility. It is obvious that neutrophils cannot survive in the presence of antineutrophil antibodies.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Neutrophil antigens: immunology and clinical implications. 40 Jul 55

A group of 49 patients with advanced non-Hodgkin's lymphoma were entered in a combination-chemotherapy protocol (cyclophosphamide L2). Of 14 patients with diffuse poorly differentiated lymphocytic lymphoma (DPDL), 64% responded with two partial remissions (PR) and seven complete remissions (CR). Both PRs are stable at 17+ months while six of the CR group are free of disease at 3+-23+ months. Fifty-three percent of 30 patients with diffuse histiocyctic lymphoma (DHL) responded with 23% attaining CR status. Of the nine PR patients, six are stable at 11+-23+ months while six of the seven CR group are without disease at 9+-27+ months. The major toxic effect was bone marrow suppression with two deaths during periods of neutropenia; one of these deaths was definitely drug related. The encouraging results in the DPDL category have led to a continuation of this protocol for patients with this histologic type. In patients with DHL other approaches are being explored.
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PMID:Cyclophosphamide L2 protocol: a combination chemotherapeutic regimen for advanced non-hodgkin's lymphoma. 86 64

Pulmonary aspergillosis in patients with leukemia or lymphoma is usually a fatal infection. However, difficulty in obtaining a premortem diagnosis has often prevented an adequate trial of anti-fungal chemotherapy. In this report, nine cases of aspergillus pneumonia in patients with hematologic malignancy were diagnosed during a one-year period. Five of nine patients had a premortem diagnosis (56%) and eight of nine (89%) received a premortem trial of amphotericin B. Two of nine patients survived infection, including one patient with prolonged neutropenia. Better diagnostic methods and wider use of antifungal chemotherapy may improve prognosis for aspergillus infection in patients with hematologic malignancy.
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PMID:Aspergillus pneumonia in hematologic malignancy. Improvements in diagnosis and therapy. 86 47

The records of 360 patients with malignant lymphoma treated with various forms of combination chemotherapy from 1966 to 1974 were reviewed. A total of 181 infections was found in 125 patients. The most frequent types of infection were pneumonia (31%), skin infections (17%), urinary tract infections (13%) and septicemia (11%). An etiologic organism was was identified in 133 infections (73%). The most common causative organisms were bacteria (77%), especially gram-negative bacilli. Viral infections accounted for 18% of the infections with 21 of the 24 being due to herpes zoster. These were more frequently found in patients with Hodgkin's disease (14/21) than in the other lymphomas. Among patients with Hodgkin's disease, 53% treated with COP developed infections compared to only 27% treated with MOPP (p = 0.039). Among patients with non-Hodgkin's lymphoma, infections were more frequent in patients treated with Adriamycin containing combinations than with COP. Neutropenia (i.e. less than 1,000 neutrophils/mm3) was associated with 35% of infections in this study and was seen more often in patients with non-Hodgkin's lymphoma (p = 0.048).
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PMID:Infections in patients with malignant lymphoma treated with combination chemotherapy. 91 45

Blood findings at diagnosis, in 140 adults with lymphoma, were correlated with bone marrow involvement and survival. An abnormal haemoglobin, leucocyte count or platelet count was found in 57% of patients. Lymphocytopenia occurred in 46%. All patients with thrombocytopenia or neutropenia, 69% with leucopenia and 63% with anaemia had marrow involvement with lymphoma. Marrow involvement in histiocytic and stem cell lymphoma was always associated with anaemia. Marrow involvement in poorly differentiated lymphocytic lymphoma (PDL) was associated with anaemia, thrombocytopenia, leucopenia, lymphocytopenia or lymphoma cells in the blood in 93% of patients. Bone marrow involvement was found in only 13% of patients with normal haematological parameters. In the absence of marrow involvement blood abnormalities at diagnosis did not generally correlate with survival. However, among patients with diffuse PDL who had marrow involvement, anaemia, thrombocytopenia and leucopenia adversely affected survival. Lymphocytopenia did not correlate with survival.
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PMID:Significance of haematological parameters in the non-Hodgkin's malignant lymphomas. 125 24

Current treatment options for acquired-immunodeficiency syndrome (AIDS)-related non-Hodgkin's lymphoma (NHL) are unsatisfactory because of excessive toxicity rates and frequent recurrence of lymphoma. In this phase II study, we evaluated a novel 12 week chemotherapy program with respect to feasibility, toxicity and therapeutic results. Thirty HIV-seropositive patients with intermediate grade or small non-cleaved cell NHL received a 12 week program of weekly intravenous and oral chemotherapy consisting of etoposide, adriamycin, cyclophosphamide, bleomycin, vincristine, methotrexate and prednisone as well as biweekly intrathecal cytosine arabinoside. Prophylaxis against Pneumocystis carinii pneumonia (PCP) and candida were given routinely. The overall objective response rate was 73% with 33% complete responders. The time to progression for those stable or responding was 9.4 months. Five of 10 complete responders are well and free of disease 13.2 to 24.5 months from diagnosis. Median survival for the 30 patients was 8.1 months. NHL was the most common cause of death (13/22); opportunistic infection caused only one death (cryptococcal meningitis). Only 1 case of PCP occurred. The major toxicity was neutropenia. In conclusion this regimen resulted in response rates similar to other reports with acceptable toxicity and a very low incidence of PCP. Relapse of NHL remains a major challenge, however, and further studies are needed. Routine PCP prophylaxis should be incorporated into new trials of therapy for AIDS-related NHL.
Leuk Lymphoma 1992 Oct
PMID:Treatment of AIDS-related non-Hodgkin's lymphoma with a twelve week chemotherapy program. 128 56

Systemic Candida infections are a major cause of infectious morbidity and mortality during chemotherapy-induced neutropenia. Because of the unreliability of conventional diagnostic tests to detect systemic infection early in its course, treatment of established disseminated Candida infection has been generally disappointing with mortality rates of 60-80% in leukemia and bone marrow transplant patients and 30-40% in solid tumor patients. The use of empiric amphotericin B in patients with fever not responding to empiric antibacterial agents has been shown to be successful in reducing morbidity and mortality from fungal infections. However, its toxicity has mitigated the success of this approach. Fluconazole given prophylactically at the institution of chemotherapy has been shown to be a safe and effective alternative. It, however, is not active against all fungal species, especially Aspergillus and some of the less virulent Candida species. Some centers have reported break-through infections by these less susceptible organisms. Whether or not these limitations in its spectrum of activity will limit its usefulness in the future remains unanswered at this time and could pose a cloud to an otherwise bright promise.
Leuk Lymphoma 1992 Nov
PMID:The use of fluconazole prophylaxis in patients with chemotherapy-induced neutropenia. 129 Sep 59

During the 20-year period, 1972-1991, 27 episodes of Staphylococcus aureus bacteremia, including 10 with methicillin-resistant strains (MRSA), were documented in 26 patients with hematologic disorders, mainly acute leukemia and malignant lymphoma, representing 6% of all 433 episodes of bacteremia in a hematology unit. MRSA replaced methicillin-sensitive strains (MSSA) in the last four years. The skin and upper respiratory tract were the two most common primary foci. Most episodes occurred during neutropenia. Pharyngeal colonization often preceded the development of bacteremia. Antibiotic therapy predisposed to MRSA acquisition during hospitalization, whereas MSSA was mostly detected in admission cultures. Among 22 patients with monomicrobial bacteremia, 19 (86%) survived longer than one week, including all four with MRSA bacteremia who received vancomycin. The survival rate did not differ materially between MRSA and MSSA bacteremias. Secondary foci, chiefly located in the lung, were found in 30% of all patients with S. aureus bacteremia. Prolonged antibiotic therapy, therefore, seems warranted in patients with evident metastatic lesions, although abbreviated therapy is proposed in neutropenic cancer patients.
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PMID:Staphylococcus aureus bacteremia in patients with hematologic disorders. 129 23


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