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Query: UMLS:C0027947 (neutropenia)
 17,527 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

During the National Influenza Immunization Program in 1976, 147 children with neoplastic diseases received Wyeth split-product bivalent influenza vaccine: A/New Jersey/8/76 (HSW1N1), A/Victoria/3/75 (H3N2). Thirteen normal siblings served as controls. Seventy-one patients received two doses of the vaccine four weeks apart. After the second injection of A/NJ/8/76, there was a difference between the response of the patients on chemotherapy and those off therapy greater than or equal to 30 days--38% vs. 76%, P less than 0.01 for four-fold rise and 26% vs. 57%, P less than 0.05 for the attainment of protective (greater than or equal to 32) hemagglutination inhibition (HI) titers. These differences were observed in both leukemia-lymphoma and solid tumor patients. There was a difference in HI titers to A/Vic/75 between patients on and off chemotherapy after a single injection, 34% vs. 71%, P less than 0.001 for a four-fold rise. After the second immunization, only 52% on, and 86% off therapy (P less than 0.05) had a four-fold rise in titers. Thirty-two percent of the patients on treatment who achieved "protective" titers did so only after the second immunization. Immunoglobulin levels and neutropenia did not correlate with the inability to obtain a four-fold rise in titers. Our findings suggest that patients on chemotherapy cannot be effectively vaccinated by a new antigen, and that single yearly boosters may be insufficient for recall of old antigens. Patients off chemotherapy greater than or equal to 30 days respond as normal controls.
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PMID:Influenza immunization of children with neoplastic diseases. 735 92

Fifty-six fibreoptic bronchoscopies were performed on 42 patents with Hodgkin's disease, lymphoma, or leukaemia and pulmonary complications which did not respond to conventional antibiotics. All these patients had received chemotherapy, radiotherapy, or both for the treatment of their underlying conditions. Twenty-two bronchoscopic procedures were complicated by thrombocytopenia and neutropenia, requiring platelet transfusion before bronchoscopy, and many patients were hypoxaemic. Visual examination of the tracheobronchial tree, alveolar lavage, bronchial brushing, and transbronchial biopsy were carried out as approximate. Three patients had minor pulmonary haemorrhage, and three developed a pneumothorax after transbronchial biopsy. A specific diagnosis was obtained in 14 of 18 patients (78%) with diffuse chest radiographic abnormalities, in seven of 11 patients (64%) with lobar or segmental (focal) abnormalities, in two of eight patients with small (local) lesions, and in three of five patients with hilar abnormalities. In only three patients were infections diagnosed. It is concluded that fibreoptic bronchoscopy is a useful and safe diagnostic procedure in this situation but its value depends upon the type of radiological abnormality.
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PMID:Fibreoptic bronchoscopy and diagnosis of pulmonary lesions in lymphoma and leukaemia. 736 Dec 80

Twenty-one consecutive patients with refractory or relapsed non-Hodgkin's lymphomas were treated with a novel combination chemotherapy (MINE-BOP), comprising myelosuppressive (ifosfamide, mitoxantrone, etoposide) and non-myelosuppressive (bleomycin, vincristine and prednisone) drugs. Median age of the patients was 42 years and all had intermediate or high-grade lymphoma. Fifteen patients had refractory disease. All patients had previously been treated with one or two regimens, containing anthracyclines. In all cases the duration between the last chemotherapy and the MINE-BOP regimen was shorter than 12 months. Response rate was 57% with 33% complete remission (CR). Median disease-free and overall survivals were 7 and 10 months respectively. The serum LDH level was the only significant prognostic factor in this study. The toxicity of this regimen was moderate with 24% of febrile neutropenia and 9% of microscopic hematuria. Toxic death due to febrile neutropenia was observed in one patient who had bone marrow involvement. To conclude, the addition of non-myelosuppressive drugs to the chemotherapy regimen and shortening the interval between the application of cytotoxic drugs as used in the present study did not show any improvement of response and survival in this group of patients.
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PMID:Mesna/ifosfamide, mitoxantrone, etoposide, bleomycin, vincristine, prednisone (MINE-BOP) combination chemotherapy in the treatment of refractory and relapsed non-Hodgkin's lymphoma. 749 84

Granulocyte--colony stimulating factor (G-CSF, filgrastim) is a glycoprotein hormone of the hematopoietin family that primarily influences the proliferation and differentiation of neutrophilic granulocytic precursors. As with all glyco-protein hormones, G-CSF interacts with target cells by binding to specific cell-surface receptors. It stimulates proliferation, differentiation and activation of cells of the neutrophil--granulocyte lineage and has been investigated as therapy for patients with various neutropenic conditions. A major use for recombinant G-CSF therapy will be in ameliorating the neutropenia which follows cytoreductive chemotherapy. The increase in neutrophils produced by this factor render it a useful treatment for conditions such as congenital, acquired and cyclic neutropenias. It may be an effective therapy in myelodysplasia and aplastic anaemia. G-CSF is also useful in accelerating the recovery of transplanted bone marrow in patients with leukaemia, lymphoma and solid tumors. G-CSF is well tolerated. The most frequently reported adverse effect is mild to moderate bone pain.
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PMID:[Biological properties and clinical application of filgrastim (G-CSF)]. 750 84

Hematopoietic growth factors, including granulocyte colony-stimulating factor (G-CSF), are being increasingly used to prevent chemotherapy-induced neutropenia. We report a patient with aggressive non-Hodgkin's lymphoma who was successfully supported with G-CSF through a weekly VACOP-B chemotherapy regimen. The patient had become severely neutropenic at week 3, requiring a one-week delay. For the remainder of the treatment, G-CSF at a dose of 4 micrograms/kg/day was administered daily over 4 days after week 4, then over 3 days thereafter, beginning the day after the non-myelosuppressive weeks (vincristine/bleomycin). A total of 5 such G-CSF courses were given, with no further neutropenia despite administration of full chemotherapy doses on schedule. This case suggests that, at least with the VACOP-B regimen, chemotherapy-induced neutropenia can be prevented using much lower quantities of G-CSF than has been reported using other regimens.
Leuk Lymphoma 1993 Nov
PMID:Prevention of chemotherapy-induced neutropenia using G-CSF with VACOP-B--a case report. 751 Jan 92

Haemopoietic growth factors are accepted as accelerating haemopoietic recovery after bone-marrow grafting, yet no large randomised trials have been published that convincingly show benefit. Lenograstim (glycosylated recombinant human granulocyte colony-stimulating factor) was given to 315 patients after bone-marrow transplantation in a prospective randomised placebo-controlled multicentre trial. 1 day after bone-marrow infusion, 163 patients received lenograstim 5 micrograms/kg per day by 30-min infusion, and 152 patients received placebo daily for 28 days or until neutrophil recovery. 137 patients had lymphoma, 35 myeloma, 85 acute lymphoblastic leukaemia, and 58 a solid tumour. Patients were stratified by age and by type of bone-marrow transplantation (BMT). Neutrophil recovery to above 10(9)/L for 3 consecutive days was seen earlier in lenograstim-treated patients (16 vs 27 days, p < 0.001). Time to neutrophil recovery above 0.5 x 10(9)/L was reduced (14 vs 20 days, p < 0.001). The difference was significant both in autograft (20 vs 14 days, p < 0.001) and allograft (20 vs 14 days, p < 0.01) patients, in children (20 vs 13 days, p < 0.001), and adults. Lenograstim-treated patients had fewer days of infection, and of antibiotic administration, and also spent less time in hospital. However, clinical and microbiological sepsis was similar in both groups. There was no significant toxicity ascribed to lenograstim. Survival was the same at days 100 and 365. In patients undergoing autologous or allogeneic BMT for neoplastic disease, lenograstim significantly reduced duration of neutropenia and led to earlier hospital discharge.
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PMID:Placebo-controlled phase III trial of lenograstim in bone-marrow transplantation. 751 Aug 13

Shwachman's syndrome is a rare congenital disorder associated with neutropenia and exocrine pancreatic insufficiency. We describe the development of acute myeloid leukemia in a 38-year-old patient with Shwachman's syndrome following three years of pancytopenia. After chemotherapy the leukemic clone was eradicated, however, the patient's bone-marrow hypoplasia persisted beyond 180 days with neutropenia that responded to administration of granulocyte colony-stimulating factor. Despite the patient's low erythropoietin levels, administration of erythropoietin did not improve his hemoglobin. We review previously reported cases of leukemia complicating Shwachman's syndrome with emphasis on the persistent risk of complications in patients with congenital bone-marrow failure syndromes.
Leuk Lymphoma 1993 Dec
PMID:Acute leukemia complicating bone marrow hypoplasia in an adult with Shwachman's syndrome. 751 52

The purpose of this trial was to evaluate the efficacy and the tolerance of high-dose therapy with autologous stem cell transplantation as part of front-line therapy in Hodgkin's disease for patients with both adverse prognostic factors: high tumor burden at presentation and slow response to initial chemotherapy. In a prospective one-center study, 20 consecutive patients with slow response (tumor reduction < 75%) (16 pts) or refractory (4 pts) to 3-4 courses of conventional HD chemotherapy received high-dose therapy followed with autologous bone marrow (14 pts) or peripheral blood stem cell (6 pts) transplantation. They were 13 males, 7 females, median age 26 years (8-45). At the time of initial diagnosis, all but one of the patients had B symptoms, all had high-risk HD defined as Ann Arbor stage IV (7 pts) or large mediastinal involvement (LMI = tumor/thorax > 0.45 at T5-T6) (6 pts) or both stage IV+LMI (7 pts). Median time between diagnosis and autotransplantation was 5 months. Intensive therapy consisted of either CBV (cyclophosphamide 1.5 g/m2 x 4, BCNU 300 mg/m2, etoposide 200 mg/m2 x 3) (12 pts) or cyclophosphamide 120 mg/kg + 12 Gy total body irradiation for 8 patients with diffuse bone or lung involvement. For pts treated with CBV, 40 Gy involved field radio-therapy was performed after hematological recovery. Median duration of neutropenia was 16 days (9-21). Neither veno-occlusive disease, nor interstitial pneumonitis nor toxic death were observed. Seventeen pts are alive with no progression of the disease (16/16 in partial response after initial chemotherapy, 1/4 with refractory disease).(ABSTRACT TRUNCATED AT 250 WORDS)
Leuk Lymphoma 1993 Dec
PMID:Early intensive therapy with autotransplantation for high-risk Hodgkin's disease. 751 54

We investigated the effects of recombinant granulocyte colony-stimulating factor (G-CSF) administration on duration of neutropenia, antibiotic therapy, and hospitalization days in 25 children with malignancies (Group A: 12 leukemia and lymphoma; Group B: 13 tumors) who were undergoing chemotherapy. We compared the effect of G-CSF with a control group of 21 children with equivalent diseases and chemotherapy that did not receive G-CSF treatment. All 25 children received 5 micrograms/kg/day of G-CSF at the end of chemotherapy courses when absolute neutrophil counts were < or = 1000/mm3. The effect of G-CSF on median neutrophil profiles, antibiotic therapy, and hospitalization days was studied for both groups at the 1st and 4th cycle of chemotherapy. During both cycles, children who received G-CSF showed a faster rise of absolute neutrophil count (P < 0.001) and fewer hospitalization days (P < 0.05), and not as many received systemic antibiotic therapy (P < 0.0001). We conclude that G-CSF accelerates neutrophil recovery in chemotherapy-induced neutropenia in childhood malignancies.
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PMID:Effect of granulocyte colony-stimulating factor on chemotherapy-induced neutropenia in children with cancer. 762 95

In high-grade malignant non-Hodgkin's lymphomas (hNHL) recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) was evaluated as support to chemotherapy. In a phase III trial, 172 patients (age 18-73 years, stage II-IV) were risk-stratified according to LDH levels and lymphoma size and randomized to receive rhGM-CSF (400 micrograms) (87 patients) or placebo (85 patients) subcutaneously days 8-14 of each cycle of an intensified COP-BLAM regimen. RhGM-CSF significantly reduced the length and nadir of neutropenia, the length of fever episodes, the frequency of all and of severe infections, and of hospitalization and antibiotic requirements. Complete response rates were 63% for all patients and 64% vs. 61% (n.s.) in the rhGM-CSF vs. the control group. Deviations from protocol in applied dosages of myelotoxic drugs and in cycle intervals maintained differed slightly in favor of the rhGM-CSF arm. However, there were no significant differences in overall survival between the GM-CSF treatment and control groups (21 vs. 23 months). Early relapse rates were markedly lower than in the standard-dose COP-BLAM/IMVP-16 regimen. Thus, GM-CSF abates toxic side effects of chemotherapy and may help to maintain dose intensity in high-risk hNHL.
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PMID:Cytokine efficiency in the treatment of high-grade malignant non-Hodgkin's lymphomas: results of a randomized double-blind placebo-controlled study with intensified COP-BLAM +/- rhGM-CSF. 751 44


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