Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-eight patients with measurable or evaluable, regionally advanced or metastatic head and neck cancer received the combination of cyclophosphamide (C), adriamycin (ADR), and a 24-hour infusion of cis-diamminedichloroplatinum (II) (P). Most patients had received extensive prior surgery and radiation therapy, but only two had prior chemotherapy. We observed a 46% response rate (13/28) which included five complete responders and eight partial responders. Nine of the 13 patients responded within the initial month of treatment. The median response duration for the 13 responding patients was 7.5 months. Moderate to severe nausea and vomiting, and alopecia were the most significant toxicities. Myelosuppression (WBC less than 4,100 cells/mm3) occurred in 90% of patients but there were no episodes of sepsis, nor did we detect any meaningful impairment in renal function.
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PMID:Cyclophosphamide, adriamycin, and 24-hour infusion of cis-diamminedichloroplatinum (II) in the management of patients with advanced head and neck neoplasms. 653 49

A new treatment program was developed in an attempt to increase the complete remission rate and survival of previously untreated patients with advanced stages of diffuse aggressive lymphomas. A flexible number of cycles of ProMACE chemotherapy (prednisone, methotrexate, doxorubicin, cyclophosphamide, and epipodophyllotoxin VP-16) was alternated with a flexible number of cycles of MOPP chemotherapy (mechlorethamine, vincristine sulfate, procarbazine, and prednisone), and finally late intensification with ProMACE therapy was given. The duration of each phase of treatment was determined by the patient's rate of tumor response. Complete remissions were achieved in 55 of 74 patients (74%) with a median duration of follow-up exceeding 2 1/2 years. Only ten of the complete responders (18%) have had relapse. The dose-limiting toxicity is myelosuppression, and eight patients (10%) died from sepsis. Median survival for all patients has not been reached but is predicted to exceed 4 years with 65% of patients alive at 4 years. Previously we achieved a 46% complete remission rate with 38% of all patients alive at 4 years; relapse-free survival beyond 2 years was tantamount to cure. Therefore, ProMACE-MOPP chemotherapy represents a substantial improvement in treating patients with diffuse aggressive lymphomas.
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PMID:Diffuse aggressive lymphomas: increased survival after alternating flexible sequences of proMACE and MOPP chemotherapy. 660 Sep 2

Thirty-two patients with advanced gynecologic malignancies were treated with m-AMSA, 120 mg/m2 intravenously every 3 weeks. Seventeen patients with advanced carcinoma of the cervix who were treated with m-AMSA had a median performance status (CALGB scale) of 2. There were two partial responses (PR) (14%) in 16 evaluable patients. The median duration of survival was 76 days following the initiation of m-AMSA treatment. In ovarian carcinoma, none of the nine evaluable patients who were treated responded. One PR occurred among four treated patients with endometrial adenocarcinoma. Toxicity was limited to myelosuppression (WBC greater than 2500/micrograms in 29/77 courses, WBC greater than 1500/micrograms in 16/77 courses, platelets greater than 100,000/micrograms in 10/77 courses, and drug-induced anemia in 7/77 courses) and mild to moderate nausea and vomiting (10/31 patients). Three patients required hospitalization for fever and granulocytopenia, and one patient died from drug-induced sepsis. Although toxicity was acceptable in this group of heavily pretreated patients, m-AMSA has limited activity in patients with advanced carcinoma of the cervix and no apparent activity in patients with advanced epithelial ovarian carcinomas. Continued trials are indicated in patients with adenocarcinoma of the endometrium.
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PMID:A phase II trial of m-AMSA in the treatment of advanced gynecologic malignancies. 689 60

After perioperative adjuvant chemotherapy of a sigma-adenocarcinoma with 400 mg peptichemio and 500 mg 5-fluorouracil a 61-year-old woman developed a severe intoxication: myelosuppression with pancytopenia, gastroenteritis and ulcerative proctitis, toxic hepato- and myocardiopathy, impaired renal function and alopecia. As a result of reduced resistance pneumonias, urinary tract infection, sepsis, cytomegaly infection and candidiasis of the oral mucosa occurred. The toxic effects are attributed mainly to the high dose of peptichemio.
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PMID:[Severe intoxication after combined chemotherapy of a sigma-adenocarcinoma with peptichemio and 5-fluorouracil (author's transl)]. 711 29

Twenty-three pediatric cancer patients developed Pseudomonas aeruginosa septicemia during an 11-year period. Typically the patients had advanced neoplasia and were receiving immunosuppressive therapy. Severe myelosuppression was almost always present and antibiotic therapy during the prior 2-week period for proven or suspected sepsis was common. Disruption of the skin and mucosa in the anogenital regions was evident in the majority of patients, and the gastrointestinal tract represented the most common portal of entry. Patients who developed sepsis while relapsed had the highest case-fatality rate, and use of synergistic antibiotic combinations did not affect outcome in this group.
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PMID:Pseudomonas aeruginosa septicemia in childhood cancer patients. 717 13

Seventy-nine patients with metastatic breast cancer underwent examination of their bone marrow as part of their staging workup. Thirty-one (39%) showed no evidence of bone marrow involvement (BM-); 48 (61%) were found to have bone marrow metastases (BM+). Both groups of patients were treated with intensive chemotherapy with 5-FU, Adriamycin, cyclophosphamide, methotrexate, and nonspecific immunotherapy with BCG, methanol extraction residue, or Levamisole. The groups were comparable in age, race, menopausal status, and disease-free interval; however, the BM+ group had a higher proportion of patients with dominant osseous disease and a somewhat lower overall tumor burden. Ten of 21 patients in the BM+ group treated with 100% of the calculated dose of chemotherapy are still alive, compared with only three of 27 patients treated with lower doses. A similar dose response was observed in the BM- group. Myelosuppression was more common and more severe in the BM+ group. Hematologic support, i.e., packed erythrocytes and platelet transfusions, was required in 60% of BM+ patients, as opposed to 26% of BM-. Infectious complications were also higher in the BM+ group, in which five episodes of sepsis and two infectious deaths were observed. These results suggest that metastatic breast cancer patients with bone marrow invasion achieve excellent palliation with aggressive high-dose chemotherapy. Higher morbidity requiring aggressive supportive care suggests that these patients should be treated by physicians and centers experienced in their management.
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PMID:Combination chemotherapy for breast cancer metastatic to bone marrow. 723 95

Ten patients with acute lymphocytic leukaemia (ALL) and four patients with acute undifferentiated leukaemia (AUL) in relapse or refractory to conventional therapy were treated with remission induction therapy consisting of an anthracycline antibiotic and cytosine arabinoside. Twelve patients had previously demonstrated resistance to vincristine-prednisone and nine patients had prior anthracycline therapy. Nine patients achieved complete remission after one course of therapy with a median time to remission of 30 d. Of five nonresponders, three died of sepsis with marrow hypocellularity and no evidence of residual leukaemia. Only two patients had unequivocal evidence for resistance to an anthracycline-cytosine arabinoside regimen. Myelosuppression and infection were the most significant complications of therapy. The data presented indicate that marrow ablative chemotherapy with an anthracycline antibiotic and cytosine arabinoside is an effective regimen for remission induction in adults with ALL and AUL refractory to vincristine-prednisone. The use of these agents in remission consolidation therapy may offer the possibility of providing a reduction in residual resistant cells that are present after successful remission induction therapy with conventional agents.
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PMID:Treatment of refractory adult acute lymphocytic leukaemia and acute undifferentiated leukaemia with an anthracycline antibiotic and cytosine arabinoside. 725 87

The clinical features of 13 patients with angioimmunoblastic lymphadenopathy were analyzed to determine prognostic factors and response to therapy. Eleven patients presented with sudden onset of fever, weight loss, generalized lymphadenopathy, and hepatosplenomegaly. Laboratory features included autoimmune hemolytic anemia and polyclonal hypergammaglobulinemia. Pulmonary involvement was seen in six cases and skin rash in four. Two patients had localized lymphadenopathy without systemic symptoms. Both are alive at 5.5 and 2.5 years, respectively, after diagnosis, although the latter patient has required intermittent prednisone for recurrent lymphadenopathy. An additional patient is alive on treatment for months following diagnosis. The remaining ten have died, nine of sepsis and one of cerebral hemorrhage. The immunosuppression and myelosuppression of combination chemotherapy may have hastened their deaths. An individualized, conservative treatment approach is recommended.
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PMID:Angioimmunoblastic lymphadenopathy: clinical spectrum of disease. 729 97

A 67-year-old woman was treated with MP-P therapy and combination chemotherapy for multiple myeloma IgG-lambda type. After the therapy for about three years, pancytopenia developed. Bone marrow aspiration study revealed a few of myeloma cell and many atypical cells showing promyelocytic feature. Chromosomal abnormality was 46, X, -X, +8, -13, +mar. CD33 and CD56 were positive, but CD16 and HLA-DR were negative. We diagnosed as multiple myeloma complicated with secondary myeloid/natural killer (NK) cell acute leukemia. After she had been treated with low dose etoposide for leukemia, she obtained complete remission. But since myeloma progressed and the amount of M protein was increased, she was treated with dexamethasone and low dose etoposide, resulting in a decrease in the amount of M protein. After that, because of leukemic cell re-proliferation, she was treated with etoposide. However, she died of sepsis due to severe myelosuppression. This case was interesting one in coexist of multiple myeloma and secondary myeloid/NK cell acute leukemia, and those affecting her clinical course each other.
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PMID:[Secondary myeloid/natural killer cell acute leukemia appeared in multiple myeloma treated with melphalan]. 756 97

We have evaluated the combination of ifosfamide, carboplatin, and etoposide (ICE) along with mesna in 46 patients with stage IV non-small cell lung cancer. Treatment consisted of ifosfamide (1.25 g/m2/d with mesna) and etoposide (80 mg/m2/d) given intravenously on days 1 to 3 and carboplatin (300 mg/m2) given intravenously on day 1 every 4 weeks. Eligibility criteria included measurable disease; adequate hematologic, hepatic, and renal functions; no prior chemotherapy; and an Eastern Cooperative Oncology Group performance status (PS) of 0 to 3. Two patients were lost to follow-up and one had received prior chemotherapy, leaving 43 patients evaluable for response and toxicities. There were 27 male and 16 female patients. Twenty-three patients had a PS of 0 or 1 and 20 had a PS of 2 or 3. Eighteen patients had received prior radiotherapy. There were two complete responses and nine partial responses. The response rate was 35% in PS 0 or 1 patients and 15% in PS 2 or 3 patients. The most frequent toxicity was myelosuppression; 44% of patients experienced grade 3 or 4 leukopenia and 14%, grade 3 or 4 thrombocytopenia. Patients receiving prior radiation were significantly more prone to develop leukopenia (P = .01). Five patients developed leukopenic fever, and three died of sepsis. Gastrointestinal toxicities were mostly mild. No neurologic or genitourinary toxicities were observed. The median length of survival was 209 days for patients with a PS of 0 or 1 and 123 days for the entire group. The 1-year survival rate was 22% and 19%, respectively, in these two patient subgroups. ICE is an active regimen in patients with metastatic non-small cell lung cancer and a good PS. Myelosuppression is the major dose-limiting toxicity. Hematopoietic growth factors may be indicated in subsequent studies, especially in patients who had prior radiation therapy. The therapeutic effect of ICE on patients with a poor PS remains unsatisfactory and requires further investigation.
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PMID:Ifosfamide/carboplatin/etoposide chemotherapy in patients with metastatic non-small cell lung cancer. 761 Mar 99


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