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)

The activity of complement-mediated opsonin was measured by the whole blood chemiluminescence method in 17 children with hematologic malignancy (including 6 with ALL, 7 with ANLL and 4 with non-Hodgkin's lymphoma) during remission induction therapy. The activity of opsonin, which was at the normal level before chemotherapy, decreased in all of the children during the therapy. This phenomenon was especially marked in the children treated with L-asparaginase. Although no clear relationship was found between the decrease in opsonin activity and the susceptibility to infection, it was confirmed that in 4 children having an episode of sepsis or septic fever, the infection started when the granulocyte decreased to the nadir, and simultaneously the activity of opsonin decreased. Therefore, it may be reasonable to suspect the decrease in opsonin activity when treating children with such infections.
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PMID:Impairment of opsonic function in children with hematologic malignancy during remission induction therapy. 399 81

Seven bone marrow transplant recipients with acute lymphoblastic leukemia receiving a mean dose rate of 0.07 Gy/min of total body irradiation towards the pelvic midpoint and the lungs had an increased (p less than 0.01) overall death rate of 86 per cent compared with 33 per cent among 27 patients with acute non-lymphoblastic leukemia or acute lymphoblastic leukemia treated with a mean dose rate of 0.04 Gy/min. Among the patients receiving the higher dose rate there was an increased mortality in causes related to radiation toxicity like early septicemia, interstitial pneumonitis and pulmonary fibrosis, compared with all patients receiving the lower dose rate (p less than 0.01) and also with 10 patients from this group with acute lymphoblastic leukemia (p less than 0.02).
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PMID:Increased mortality by septicemia, interstitial pneumonitis and pulmonary fibrosis among bone marrow transplant recipients receiving an increased mean dose rate of total irradiation. 632 71

Eleven adults have been transplanted for various reasons between July 1979 and July 1982: 2 with aplastic anemia (AA), 1 with paroxysmal nocturnal hemoglobinuria (PNH), 8 with acute leukemia (AL). Four patients suffered from acute lymphocytic leukemia (ALL) and four from acute non-lymphocytic leukemia (ANLL). Two of them were transplanted in relapse, 1 in a partial remission, and 5 in complete remission. All patients were in their late stage of disease. The PNH-patient had an identical twin, 8 patients had an HLA- and MLC compatible sib, 1 an unrelated donor, and 1 was transplanted from his father. Four patients are alive, 2 more than 3 years: 1 with AA and 1 with ALL who was transplanted in relapse. Six patients died of infectious complications (4 of interstitial pneumonia, 1 of a candida sepsis, 1 of acute toxoplasmosis). Patients living more than 3 weeks had a take. Acute graft-versus-host (GvH) disease did not present a major problem. All patients received methotrexate for GvH-prophylaxis, in three instances the marrow was additionally pre-incubated with anti-T-cell globulin.
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PMID:[Bone marrow transplantation in adults in acute leukemia, aplastic anemia and paroxysmal nocturnal hemoglobinuria. Results of the Medical Clinic IIi of LMU (Ludwig-Maximilians University) Munich]. 634 18

During 59 periods of hospitalisation, 39 patients with either acute myeloid leukemia (22), acute lymphatic leukemia (9), acute undifferentiated leukemia (1), blastic crisis of chronic myeloid leukemia (6) or high-grade malignant non-Hodgkin lymphoma (1) were subjected to aggressive polychemotherapy after selective decontamination of the gut. The patients were given an amphotericin B suspension in a dosage of 1.2 g/day for two days, after which one tablet of trimethoprim/sulphamethoxazole (TMP/SMZ) (160 mg TMP and 800 mg SMZ) t.i.d. was added to prevent endogenous infections by gram-negative aerobic bacteria or moulds and to maintain the "colonisation resistance" endowed by the anaerobes. During 16 of the 59 periods of hospitalisation, no potentially pathogenic aerobic bacteria were isolated. TMP/SMZ-resistant Escherichia coli were the etiological agent of septicemia in two patients, and resistant Klebsiella pneumoniae and Pseudomonas aeruginosa in two other patients. These bacteria were cultured from the patients' fecal samples prior to the development of septicemia. We observed that long-term prophylaxis with TMP/SMZ modified the normal aspect of the fecal biotop culture, not only by suppressing the aerobic gram-negative bacteria, but also by allowing certain clostridia to appear. We differentiated 207 clostridia from the fecal samples of 29 patients and observed a predominance of TMP/SMZ-resistant Clostridium difficile, Clostridium innocuum and Clostridium clostridiiforme. C. difficile was also isolated from the blood culture of a neutropenic patient treated with TMP/SMZ and proved to be very toxic in the Verocell culture.
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PMID:The "clostridial effect" of selective decontamination of the human gut with trimethoprim/sulphamethoxazole in neutropenic patients. 635 9

A total of 47 patients with relapsed or primarily refractory leukemia were treated with mitoxantrone alone or in combination with vincristine sulfate and prednisone or cytarabine. Eligible patients included those with adequate renal and hepatic function, normal left ventricular ejection fraction, and those who had received previous treatment. When mitoxantrone was given alone in a once daily times five schedule, 5 of 12 acute lymphoblastic leukemia patients achieved complete remission; 4 of these patients had been refractory to reinduction and 1 to induction chemotherapy with anthracycline-containing treatments. Four of these patients had progressive disease, and three died during induction. Of 12 patients with acute myeloid leukemia, 1 had a complete remission, 1 had a partial remission, 8 had progressive disease, and 2 died during induction. Mitoxantrone was also found to be active in two patients in the blastic transformation of chronic myeloid leukemia with a response in one patient lasting 17 weeks. Combinations of mitoxantrone with vincristine sulfate and prednisone resulted in complete remission in four of nine acute lymphoblastic leukemia patients and one of four patients with Tdt-positive chronic myeloid leukemia in blast crisis. Three of these patients had not experienced a prior remission following anthracycline-containing treatments. Partial remission occurred in two of the acute lymphoblastic leukemia patients and one of the Tdt-positive chronic myeloid leukemia patients. Two of this latter group of patients died in induction. Treatment with mitoxantrone and cytarabine resulted in two acute myeloid leukemia patients achieving complete remission and one a partial remission; two patients had progressive disease, and one died in induction. No response was seen in a patient with Tdt-negative chronic myeloid leukemia after two courses of treatment. One patient with acute leukemia in the course of myelofibrosis died in induction. All the patients achieving complete remission are alive and have been in complete remission from 2 to 12 months. Side effects included mild nausea and vomiting in 9 of 13 patients treated with the mitoxantrone-vincristine sulfate-prednisone combination, and in 3 of 8 patients treated with the mitoxantrone-cytarabine combination. Other side effects of the combination treatments include drug-induced oral mucositis (of a lesser degree than with mitoxantrone alone), transient hepatic abnormalities, and infectious complications, such as sepsis, Candida sp colonization of the upper digestive tract, and soft tissue cellulitis, in a few patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Mitoxantrone as a single agent and in combination chemotherapy in patients with refractory acute leukemia. 638 64

Thirty patients with advanced acute leukemia and lymphoma were treated with the sequential combination of high dose ARA-C (HiDAC 3 gm/m2 infused i.v. over 3 h at 0, 12, 24, 36 h) and asparaginase (ASP 6.000 IU/m2 i.m. at hour 42). The sequence was given on day 1 and 8 irrespective of the degree of myelosuppression. Of 22 patients with leukemia there was only one who was absolutely refractory to therapy. Complete remission was induced in 3 patients with ANLL (30%) and in 3 with ALL (30%). Three patients became hypoplastic but recovered with blasts and 12 died from infection, complicated by intracranial hemorrhage in 3, during hypoplasia. Of 8 patients with lymphoma, 2 were clearly refractory to therapy, one died from sepsis and the remaining 5 all entered remission (2 CR + 3 PR, 62%). Activity of HiDAC/ASP against CNS disease is suggested by the clinical response seen in patients with overt meningeal or intracerebral involvement. Toxicity associated with HiDAC/ASP was mainly hematologic. All but one patient experienced hypoplasia and severe pancytopenia; documented infections and major hemorrhages occurred in 80 and 20% of patients respectively. We conclude that HiDAC/ASP is a regimen with definite activity against acute leukemia and lymphoma including CNS disease. Alternate treatment schedules should be explored in order to reduce marrow toxicity.
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PMID:Sequential combination of high dose ARA-C (HiDAC) and asparaginase (ASP) for the treatment of advanced acute leukemia and lymphoma. 647 2

C-reactive protein (CRP) was evaluated as an indicator of septic bacterial infections in children with acute lymphoblastic leukemia (ALL). Thirty-five children with newly diagnosed ALL and 10 children receiving antileukemic chemotherapy developed 13 episodes of verified septicemia. Newly diagnosed ALL alone influenced the CRP level moderately; half of the children with no concomitant bacterial infection had measurable CRP values. However, the CRP values in this group were significantly lower than those in children with proved septicemia in whom the CRP level ranged from 15 to 340 mg/liter (median, 125 mg/liter). We conclude that CRP levels exceeding 100 mg/liter indicate bacterial septicemia with a high specificity regardless of the stage of ALL. Moreover, a negative CRP value virtually excludes septicemia. Patients ith moderately elevated CRP values, i.e. under 100 mg/liter, should be closely observed. Sequential CRP determinations are useful in children with invasive bacterial infections.
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PMID:C-reactive protein in rapid diagnosis and follow-up of bacterial septicemia in children with leukemia. 657 7

Severe infections during the course of childhood ALL were surveyed as a whole in 100 consecutive patients, followed up for 2-8.5 years from the ALL diagnosis. The most important findings were a total absence of disseminated candidiasis, a relative infrequency of gram-negative septicemia (8 episodes), and a predominance of gram-positive cocci (29 episodes) in the 48 verified septicemias. S. aureus was responsible for 50% of culture-positive septicemias. The gram-positive predominance depended probably on local factors, and reservation in using broad-spectrum antibiotics might have played a part. There were 9 cases of disseminated Varicella-zoster, cured successfully with antiviral agents. Pneumocystis carinii pneumonitis numbered 8 episodes, concentrated to the early remission period. One case of miliary tuberculosis was found. Risk factors regarding age of patient and phase or intensity of cytotoxic therapy are evaluated.
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PMID:Severe infections in childhood leukemia. A follow-up study of 100 consecutive ALL patients. 658 42

Cefoxitin (CFX) at a daily dose of 3 to 12 grams was administered to patients who had hematopoietic disorders as underlying diseases and having severe infections. Efficacy and safety of the drug were evaluated. The underlying diseases in the 64 patients included in the evaluation of efficacy were acute myelocytic leukemia (30 cases), acute lymphocytic leukemia (9), acute promyelocytic leukemia (3), acute monocytic leukemia (2), chronic myelocytic leukemia-blastic crisis (10), erythroleukemia (2), malignant lymphoma (2), aplastic anemia (2), and others (4). The infections were septicemia in 3 patients, suspected septicemia in 47, respiratory tract infections in 7, oral infections in 3, urinary tract infections in 2, and others in 2. The clinical efficacy of CFX was 'excellent' in 13 patients, 'good' in 26, 'fair' in 6, 'poor' in 19 for an efficacy rate of 60.9%. The efficacy rate classified according to infections was 66.7% in septicemia, 66.0% in suspected septicemia, 42.9% in respiratory tract infections and 66.7% in oral infection. The organisms isolated from the patients with septicemia were E. coli in 2 patients and B. cereus in 1. B. cereus was not susceptible to CFX. The efficacy rate was 60.0% in the 10 patients whose causative organisms were identified and 61.1% in the 54 patients whose causative organisms were not identified. There was no significant difference in the efficacy rate between the patients who had failed to respond to prior antibiotic therapy and those treated with CFX from the beginning. The efficacy rates for the former group (23 patients) and for the latter group (41 patients) were 56.5% and 63.4%, respectively. The efficacy rate in patients with an initial neutrophil count less than 500/mm3 (35 cases) and from 501 to 1,000/mm3 (13 cases) were 57.1% and 76.9%, respectively. Side effects which might have been caused by CFX were skin eruptions in 2 patients (2.6%) and transient elevation of GOT and GPT in 1 patient (1.3%) among 76 patients who were evaluated for safety. CFX was considered to be a markedly useful and safe drug in the treatment of patients with hematopoietic disorders who developed severe infections.
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PMID:[Effects of cefoxitin in the treatment of severe infections in patients with hematopoietic disorders]. 675 59

Phase I clinical studies of 4'-(9-acridinylamino)methanesulfon-m-anisidide (AMSA) using several dose schedules have shown acceptable toxicity and antitumor responses in acute leukemia and several carcinomas. Thirty-eight children with acute leukemia and non-Hodgkin's lymphoma were treated with AMSA in a total dose of 140 to 600 mg/sq m given as a daily i.v. infusion in 2 to 5 days. Maximal tolerated dose was 600 mg/sq m given in 5 days. Complete and partial remissions were seen in four of 18 patients with acute lymphocytic leukemia, zero of eight patients with acute nonlymphocytic leukemia, and one of five patients with non-Hodgkin's lymphoma. Marrow aplasia and remissions were also seen with lower doses. The major toxic effects were mucositis, fever, and sepsis which were dose related. Mild nausea and vomiting, transient elevation of serum glutamic oxaloacetic-acid-transaminase, and bilirubin were noted. All of these patients had had prior anthracycline therapy. Abnormal echocardiograms were seen in 14 of 23 patients who had echocardiograms done before and after AMSA. Seven developed congestive heart failure in association with sepsis in five and with epicardial disease in one. We conclude that AMSA possesses significant activity in childhood leukemia and lymphoma and that studies of AMSA in combination with other effective agents should be done.
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PMID:Phase II study of 4'-(9-acridinylamino)methanesulfon-m-anisidide (NSC 249992) in children with acute leukemia and lymphoma. 689 64


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