Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a series of 84 patients with acute myelogenous leukemia, 24 died within 6 weeks of starting treatment. Twenty of the 24 patients had failed to achieve remission at the time of death. Death was due to infection in 20 patients and in 17 of these to septicemia; but whereas severe local infection with septicemia accounted for 12 deaths, only five patients died of septicemia without local infection. Bleeding was the direct cause of death in only four patients and an associated terminal event in another three; of these four patients three had disseminated intravascular coagulopathy. Surprisingly, in this group of patients age and overall clinical status at the time of admission were of no prognostic value in the first 6-week period. The importance of drug resistent disease associated with intractable local infection as a major cause of early death is emphasized.
Cancer 1977 Apr
PMID:Early deaths in acute myelogenous leukemia. 26 48

A 4-year-old boy with acute lymphoblastic leukemia in relapse with documented septicemia due to group C Streptococci (Streptococcus equisimilis) is described. The patient responded well to therapy with appropriate cytotoxic and antimicrobial agents. There is a general lack of recognition of the pathogenicity of group C Streptococci in man. The potential opportunistic nature of these organisms in immunocompromised hosts and the need for early recognition and appropriate treatment of such infection is emphasized.
Cancer 1979 Oct
PMID:Septicemia due to Streptococcus equisimilis in a child with acute lymphoblastic leukemia. 29 65

The case of a 49-year-old man with the diagnosis of angioimmunoblastic lymphadenopathy is reported. The patient survived a stormy clinical course. The corticosteroids improved dramatically the clinical picture although the patient developed a staphylococcal septicemia. Before treatment immunological studies were done including quantitation of B and T-cells, antigen stimulation of lymphocytes in vitro, skin tests and skin window. Impairment of cell mediated immunity, decreased T-lymphocytes and increased B-lymphocytes were found. A decreased migration of lymphocytes in the skin window was also found compatible with immunosuppression. A possible presumptive pathogenetic mechanism is described although the cause of this recently described entity remains unknown.
Cancer 1978 Aug
PMID:Angioimmunoblastic lymphadenopathy: a T-cell deficiency. 30 80

A subpopulation of human lymphocytes bearing receptors for the Fe portion of IgG causes lysis of nucleated target cells in the presence of antibody. The reaction is known as antibody-dependent cellular cytotoxicity (ADCC) and the effector cells have been called killer (K) cells. We have measured K cell activity quantitatively in the peripheral blood of cancer patients using 51Cr labeled murine mastocytoma target cells and hyperimmune rabbit antimastocytoma antibody. ADCC was the same in males and females, was not affected by eating, smoking or the presence of infections, but was decreased in those over 65 years, during pregnancy, and in those with cachexia, or severe sepsis associated with nonmalignant diseases. It was normal in those with cancers being treated for cure and in those with benign diseases, but was decreased in those with advanced cancers. Operation did not produce a significant change in those who were not immunodepressed; in those who were immunodepressed before operation it caused a significant decrease maximal by the fifth day with recovery by the 15th day. Radiotherapy caused a decrease in K cell activity, maximal at 4 weeks, that persisted for 12 weeks with recovery after that time in those who did not have residual tumor. The values did not return to normal in those who had persistent tumor or distant metastases.
Cancer 1979 Jul
PMID:Effect of operation and radiotherapy on antibody-dependent cellular cytotoxicity. 31 42

Hemorrhagic gastritis is the most frequent cause of upper gastrointestinal bleeding in patients with cancer. A study was undertaken to evaluate the clinical course of 87 patients, in a cancer hospital setting, with hemorrhagic gastritis associated with stress, exogenous gastric irritants and the combination of the two. The average number of blood transfusions was four times higher and the average duration of bleeding was twice as long in stress patients as in patients without stress. Fifty-four per cent of stress patients died, whereas all patients survived in the group without stress. Although there were no statistically significant differences, patients with the combination of gastric irritants and stress tended to bleed longer and have a higher mortality than patients with stress alone. Over two-thirds of the deaths were ascribed to associated stress risk factors such as sepsis, multiple organ failure and advanced cancer and not to gastrointestinal hemorrhage.
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PMID:Risk factors and mortality in patients with cancer and hemorrhage from stress ulcer. 31 7

This brief review of abdominal emergencies is by no means encyclopedic. Indeed, it simply reflects the multiplicity of problems that can occur and suggests the need for a high index of suspicion and an optimistic attitude toward their solution. In addition, the surgeon must keep in mind the fact that cancer patients may also suffer acute abdominal distress from extra-abdominal causes such as pneumonia, myocardial infarction, diabetes mellitus, and hematologic abnormalities such as porphyria or sickle cell anemia. Inflammatory bowel disease, pelvic inflammatory disease, acute hepatitis or other similar problems more commonly seen in general hospital populations may also develop. Consultations for an acute condition of the abdomen in patients receiving marrow-suppressing chemotherapy are challenging problems and repeated examination every few hours is required to detect subtle changes. Hypovolemia, sepsis, confusion and unexplained metabolic acidosis may be the only criteria for surgical exploration. An unnecessary operation in a leukopenic and thrombocytopenic patient is indeed risky, but failure to drain an occult abscess or resect a perforated segment of bowel is always lethal. An additional consideration is the likelihood of response to further treatment of the underlying disease. Unless further effective therapy is unavailable, pessimism is unwarranted.
Curr Probl Cancer 1979 Oct
PMID:Abdominal emergencies. 31 58

All of the febrile episodes occurring in 494 adults with acute leukemia were reviewed. There were an average of 2.39 febrile episodes per patient and the patients spent 28% of their days in the hospital with fever. Sixty-four percent of the febrile episodes were due to infection. The most common types of infection were disseminated infection and pneumonia, which together accounted for 69% of the total episodes of documented infection. The etiologic agent was identified in 73% of the documented infections and gram-negative bacilli were responsible for the great majority. The most common gram-negative bacilli causing infection were Escherichia coli, Klebsiella spp. and Pseudomonas aeruginosa. During the course of their leukemia, 31% of the patients had repeated episodes of infection caused by the same organism and 13% ahd repeated FUO's. Fever occurred most often when the patients had neutropenia (less than 500/mm3). The fatality rate from septicemia decreased from 84% in 1966 to 44% in 1972. The fatality rate for major infections caused by gram-positive cocci was 16%, for gram-negative bacilli was 37% and for fungi was 86%. Although infection remains a serious problem in leukemia patients, considerable progress has been made.
Cancer 1978 Apr
PMID:Fever and infection in leukemic patients: a study of 494 consecutive patients. 34 1

A man received a cadaver renal allograft for end-stage renal failure. After 35 months of immunosuppressive therapy with azathioprine and prednisone, he developed septicemia and a high leukocyte count. In spite of successful treatment of the infection, the leukocyte count continued to rise and a diagnosis of Philadelphia chromosome positive chronic granulocytic leukemia was made. An increased incidence of malignant disease, especially lymphoreticular malignancy, is well described in immunosuppressed patients with allografts. However, the association of chronic granulocytic leukemia and immunosuppressive therapy previously has not been reported. An additional etiological factor in this patient may have been the extensive diagnostic radiological investigations undertaken in childhood. The recent addition of allopurinol to the immunosuppressive therapy has normalized the platelet and leukocyte counts, probably by potentiating mercaptopurine.
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PMID:Chronic granulocytic leukemia in a patient with a renal allograft. 35 95

Because of the persistently high mortality from sepsis in cancer patients, a retrospective study was designed to identify the causative organisms and to determine the factors affecting the outcome of sepsis. A total of 84 episodes of septicemia in 61 children with cancer were studied. The more frequently isolated organisms were: Staphylococcus aureus (21.4%); Escherichia coli (18%); Klebsiella (7.1%); Pseudomonas (6%); and Bacteroides fragilis (6%). Other isolates included Proteus, Serratia, Acinetobacter, hemolytic Streptococcus, and Bacillus cereus. In 10.7% of septic episodes, mixed bacterial infections were documented. Twenty-four (28.6%) resulted in death; in 13 (54%) death occurred within 24 hours after admission. The fatality rate was high in cases associated with absolute polymorphonuclear leukocyte counts of less than 100/cu mm, in neoplastic relapse, and when infection with gram-negative, anaerobic and mixed bacterial flora occurred.
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PMID:Septicemia in children with cancer. 37 Oct

DDMP, a diaminopyrimidine folate antagonist, was given to 26 tumor patients in a dosage of 50 mg/m2 per week orally, simultaneously with 3 mg CF i.m. or i.v. The CF dose was increased to 30 mg in patients showing evidence of toxicity, and withdrawn in the absence of toxicity. The dose-limiting toxicity was seen in myelosuppression, particularly thrombopenia and skin rashes. At the 3 mg CF level, 18 out of 26 patients developed toxicity. No toxicity was seen at the 30 mg CF level in 11 patients. After cessation of CF, toxicity occurred in five out of seven patients. After the onset of toxicity, CF was added as a delayed rescue, in a dosage of 15 mg every 8 h or 30-60 mg daily. One patient died of sepsis with agranulocytosis. All other patients recovered from myelosuppression within 1 or 2 weeks. Objective responses were observed in seven patients, four of the ten with epidermoid cancer of the head and neck, two out of eight with epidermoid cancer of the lung, and one out of three with melanoma.
Cancer Chemother Pharmacol 1978
PMID:Initial clinical experience with a simultaneous combination of 2,4-diamino-5(3',4'-dichlorophenyl)-6-methylpyrimidine (DDMP) with folinic acid. 37 10


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