Zahide Orhan Ok, Serhan Kupeli, Gulay Sezgin, Ibrahim Bayram
Febrile neutropenia (FEN) is a significant side effect after chemotherapy, and it is known that using granulocyte colony-stimulating factor (G-CSF) has positive effects on treatment results. In this study, the effects of different G-CSF doses (5 to 10 mcg/kg/day) on treatment results in patients with high-risk FEN were evaluated. A total of 124 high-risk FEN episodes of 62 patients were enrolled in the study between June 2017 and October 2018. The episodes were divided into 2 groups according to G-CSF treatment doses, they received from 5 to 10 mcg/kg/day...
September 9, 2020: Journal of Pediatric Hematology/oncology
Elyse G Mark, W Christopher Golden, Maureen M Gilmore, Anna Sick-Samuels, Melanie S Curless, Lawrence M Nogee, Aaron M Milstone, Julia Johnson
OBJECTIVE: To summarize and evaluate current reports on community-onset severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in young infants. STUDY DESIGN: We performed a systematic review to identify reports published from November 1, 2019, until June 15, 2020, on laboratory-confirmed community-onset SARS-CoV-2 infection in infants less than 3 months of age. We excluded studies reporting neonates with perinatal COVID exposure and diagnosis prior to hospital discharge and hospital-onset disease, as well as clinically diagnosed cases without confirmation...
September 7, 2020: Journal of Pediatrics
I Ranathunga, N R Muthumala, H W C K Kulathilake, S Weerasinghe, N L A Shyamali
Background: Bone marrow necrosis (BMN) is a rare entity which presents with bone pain, fever, and peripheral cytopenia. Acute lymphoblastic leukaemia (ALL) is characterized by malignant proliferation of immature lymphocytes, and patients usually present with fatigue and bleeding manifestations. Presentation with BMN is an extremely rare finding and only few cases had been reported in the literature. Case Presentation . A 22-year-old male presented with nocturnal lower back ache, pleuritic central chest pain, and fever for two weeks...
2020: Case Reports in Hematology
Shanshan Ding, Jun Ma, Xingguo Song, Xiaohan Dong, Li Xie, Xianrang Song, Lisheng Liu
Background: Procalcitonin (PCT), C-reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) have emerged as important markers of inflammation, and these markers, especially PCT and CRP, have been studied in patients with neutropenia. This study was designed to evaluate their value in differentiating infectious fever from tumor fever (TF) and to investigate their role in assessing outcomes in nonneutropenic lung cancer patients (NNLCPs). Methods: This retrospective clinical study included 588 febrile NNLCPs between January 2019 and December 2019...
2020: Journal of Oncology
Khoirunnisa Khoirunnisa, Allenidekania Allenidekania, Happy Hayati
Febrile neutropenia is a complication of chemotherapy that occurs in children with cancer. This paper aimed to provide an overview of the application of the Levine Energy Conservation Model for treating fever neutropenia in children with cancer. The method involved a case study of five children with cancer treated for febrile neutropenia using the nursing process approach. The nursing process, according to the Levine Energy Conservation Model, focuses on increasing the body's adaptability through four forms of conservation, namely, the conservation of energy, personal integrity, structural integrity, and social integrity...
June 25, 2020: Pediatric Reports
Sabahat Ceken, Habip Gedik, Gulsen Iskender, Meryem Demirelli, Duygu Mert, Goknur Yapar Toros, Tugce Nur Yigenoglu, Fevzi Altuntas, Berna Oksuzoglu, Mustafa Ertek
INTRODUCTION: We aimed to evaluate the epidemiology of infections and factors associated with mortality in patients with febrile neutropenia (FEN). METHODOLOGY: The adult patients, who developed FEN after chemotherapy due to a hematologic malignancy or a solid tumor in a training and research hospital were evaluated, retrospectively. The demographic data of the patients, underlying malignancy, administered antimicrobial therapy, microbiological findings, and other risk factors associated with mortality were evaluated...
August 31, 2020: Journal of Infection in Developing Countries
Courtney D DiNardo, Abhishek Maiti, Caitlin R Rausch, Naveen Pemmaraju, Kiran Naqvi, Naval G Daver, Tapan M Kadia, Gautam Borthakur, Maro Ohanian, Yesid Alvarado, Ghayas C Issa, Guillermo Montalban-Bravo, Nicholas J Short, Musa Yilmaz, Prithviraj Bose, Elias J Jabbour, Koichi Takahashi, Jan A Burger, Guillermo Garcia-Manero, Nitin Jain, Steven M Kornblau, Philip A Thompson, Zeev Estrov, Lucia Masarova, Koji Sasaki, Srdan Verstovsek, Alessandra Ferrajoli, William G Weirda, Sa A Wang, Sergej Konoplev, Zhining Chen, Sherry A Pierce, Jing Ning, Wei Qiao, Farhad Ravandi, Michael Andreeff, John S Welch, Hagop M Kantarjian, Marina Y Konopleva
BACKGROUND: Venetoclax combined with hypomethylating agents is a new standard of care for newly diagnosed patients with acute myeloid leukaemia (AML) who are 75 years or older, or unfit for intensive chemotherapy. Pharmacodynamic studies have suggested superiority of the longer 10-day regimen of decitabine that has shown promising results in patients with high-risk AML in phase 2 trials. We hypothesised that venetoclax with 10-day decitabine could have improved activity in patients with newly diagnosed AML and those with relapsed or refractory AML, particularly in high-risk subgroups...
September 4, 2020: Lancet Haematology
Iqra Almas, Samia Afzal, Hamna Imtiaz, Mahrukh Akbar Shaheen, Muhammad Daud, Anam Saghir, Iram Amin, Muhammad Shahid, Muhammad Idrees
Induction of highly pathogenic hepatitis C virus (HCV) causes chronic hepatitis round the world. This virus is easily prone to developing resistance against antiviral drugs because of two viral polymerases that do not possess the proofreading and overlapping reading frame abilities. There is more than one explanation for how this virus builds up resistance against antiviral drug treatments. Assays are now available to detect HCV-resistant variants, based on phenotypic and genotypic assays, and next generation sequencing...
2020: Critical Reviews in Eukaryotic Gene Expression
Andrew M Peseski, Mitchell McClean, Steven D Green, Cole Beeler, Heiko Konig
INTRODUCTION: Febrile neutropenia represents one of the most common treatment-associated complications in the management of acute myeloid leukemia (AML) and is considered an oncologic emergency. Rapid and detailed workup as well as the initiation of empiric broad-spectrum antibiotic therapy is critical to avoid sepsis and to reduce mortality. Although a definitive source of infection is frequently not identified, the severely immunosuppressed status of the AML patient undergoing cytotoxic therapy results in a high risk for a wide array of bacterial, fungal and viral etiologies...
September 7, 2020: Expert Review of Anti-infective Therapy
Reza Zonozi, Zachary S Wallace, Karen Laliberte, Noah R Huizenga, Jillian M Rosenthal, Eugene P Rhee, Frank B Cortazar, John L Niles
OBJECTIVE: Late-onset neutropenia (LON) is an underrecognized complication of rituximab. Our objective is to describe its incidence, risk factors, clinical features, management, and recurrence. METHODS: We conducted a single-center retrospective cohort study of 738 adult patients with autoimmune disease treated with rituximab-induced continuous B cell depletion. The primary outcome was LON, defined as an unexplained absolute neutrophil count < 1000 cells/µL during B cell depletion...
September 6, 2020: Arthritis & Rheumatology
Shun-Ichi Kimura, Yoshinobu Kanda, Masaki Iino, Takahiro Fukuda, Emiko Sakaida, Tatsuo Oyake, Hiroki Yamaguchi, Shin-Ichiro Fujiwara, Yumi Jo, Akinao Okamoto, Hiroyuki Fujita, Yasushi Takamatsu, Yoshio Saburi, Itaru Matsumura, Jun Yamanouchi, Souichi Shiratori, Moritaka Gotoh, Shingen Nakamura, Kazuo Tamura
OBJECTIVES: The D-index is defined as the area over the neutrophil curve during neutropenia. The CEDMIC trial confirmed the noninferiority of D-index-guided early antifungal therapy (DET) using micafungin to empirical antifungal therapy (EAT). In this study, we evaluated the efficacy and safety of micafungin in these settings. METHODS: From the CEDMIC trial, we extracted 67 and 113 patients who received micafungin in the DET and EAT groups, respectively. Treatment success was defined as the fulfillment of all components of a five-part composite end point...
September 3, 2020: International Journal of Infectious Diseases: IJID
Kaitlin Shinn, Martha Wetzel, Nicholas P DeGroote, Frank Keller, Michael Briones, James Felker, Sharon Castellino, Tamara P Miller
BACKGROUND: Polymerase chain reaction (PCR) respiratory viral panel (RVP) testing is often used in evaluation of pediatric cancer patients with febrile neutropenia (FN), but correlation with adverse outcomes has not been well characterized. PROCEDURE: A retrospective cohort of all children ages 0-21 years with cancer admitted to Children's Healthcare of Atlanta for FN from January 2013 to June 2016 was identified. Patient demographic and clinical variables such as age, RVP results, length of stay (LOS), and deaths were abstracted...
September 2, 2020: Pediatric Blood & Cancer
Yuka Sogawa, Makoto Fukui, Shingen Nakamura, Kimiko Sogabe, Ryohei Sumitani, Masami Yoshioka, Masahiro Abe, Daisuke Hinode
The aim of this study is to investigate the association between chemotherapy-induced fever with neutropenia less than 1500/μL (FwN) and oral bacteria and/or oral immunity in patients with hematological cancer. Thirty-two patients with hematological cancer were enrolled in the study. Secretory immunoglobulin A (sIgA) in saliva and the anaerobic bacteria in tongue coating of each subject were assessed before the first chemotherapy. Eleven subjects had an onset of FwN and 21 subjects did not during the observation periods...
September 3, 2020: International Journal of Hematology
Ryoji Kobayashi, Satoru Matsushima, Daiki Hori, Hirozumi Sano, Daisuke Suzuki, Kenji Kishimoto, Takaaki Nakano, Masato Yanagi, Kouya Kodama, Kunihiko Kobayashi
BACKGROUND: The risk factors for invasive fungal infection (IFI) have gradually become evident for pediatric patients with hematological diseases. Here we analyzed the efficacy of liposomal amphotericin (L-AMB) for pediatric patients with febrile neutropenia using prophylactic voriconazole (VRCZ). METHOD: We administered L-AMB (2.5mg/kg/day) in patients with febrile neutropenia who were receiving prophylactic VRCZ (10mg/kg/day, orally) and were resistant to second line antibiotics therapy...
August 31, 2020: Pediatrics International: Official Journal of the Japan Pediatric Society
Ningning Dong, Yongdong Wu, Chenxin Song, Mingyu Wang, Yue Jiao, Shutian Zhang
PURPOSE: To investigate the efficacy and safety of gemcitabine plus capecitabine in elderly patients with anthracycline- and taxane-pretreated metastatic breast cancer (MBC). METHODS: Eligible patients received gemcitabine 1,000 mg/m2 on days 1 and 8, and capecitabine 1,000 mg/m2 twice daily on days 1-14. The treatment was repeated every 3 weeks for a maximum of 6 cycles. The primary endpoint was objective response rate (ORR). The secondary endpoint included progression-free survival (PFS), overall survival (OS), and toxicity...
May 2020: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Jonathan Mertens, Yassine Laghrib, Chris Kenyon
We present a case report of a 54-year-old male with metastasized nasopharyngeal carcinoma presenting to the hospital with dyspnea, anorexia and fever. Examination revealed chemotherapy-induced pancytopenia. The patient tested positive for SARSCoV-2, but respiratory complications were mild. The patient was treated with granulocyte-colony stimulating factor (G-CSF) leading to amelioration of the neutropenia. However, severe acute respiratory distress syndrome (ARDS) occurred, prompting the diagnosis of immune reconstitution inflammatory syndrome (IRIS)...
August 2020: Open Forum Infectious Diseases
Anish Paudel, Rashmi Dhital, Gabriel Areoye, Sijan Basnet, Niranjan Tachamo
Introduction: Gilteritinib is a FLT3 kinase inhibitor approved for FLT3-mutated acute myeloid leukemia (AML). We present a case of febrile neutropenia and neutrophilic dermatosis consistent with Sweet's syndrome (SS). Case history: A 55-year-old woman presented with fever and skin lesions after 4 weeks of initiation of Gilteritinib for AML. She was febrile, pancytopenic and neutropenic with absolute neutrophil count (ANC) of 0.1x10E3/UI. Examination revealed reddish and violaceous rashes on her extremities...
June 14, 2020: Journal of Community Hospital Internal Medicine Perspectives
Y Wang, S Luo, C S Zhou, Z Q Wen, W Chen, W Chen, W H Liao, J Liu, Y Yang, J C Shi, S D Liu, F Xia, Z H Yan, X Lu, T Chen, F Yan, B Zhang, D Y Zhang, Z Y Sun
BACKGROUND: Multicentre cohort investigations of patients with coronavirus disease 2019 (COVID-19) have been limited. We investigated the clinical and chest computed tomography characteristics of patients with COVID-19 at the peak of the epidemic from multiple centres in China. METHODS: We retrospectively analysed the epidemiologic, clinical, laboratory, and radiological characteristics of 189 patients with confirmed COVID-19 who were admitted to seven hospitals in four Chinese provinces from 18 January 2020 to 3 February 2020...
August 27, 2020: Hong Kong Medical Journal
Dov Tschernin, Yariv Fruchtman, Ruslan Sergienko, Odeya David, Ron Leibovitz, Julia Mazar, Eugene Leibovitz
BACKGROUND: To describe the etiologic, microbiologic, clinical and outcome characteristics of acute neutropenia (absolute neutrophil count, ANC, <1.5 × 109 /L) in hospitalized immunocompetent children. METHODS: Serious bacterial infections (SBI) were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, alveolar pneumonia, Brucellosis and Rickettsiosis. RESULTS: 431/671 (64.2%) healthy infants and children hospitalized with acute neutropenia were <2 years of age; 176 (40...
August 12, 2020: Pediatrics and Neonatology
Engin Kose, Ozge Besci, Elif Gudeloglu, Suzan Suncak, Yesim Oymak, Selime Ozen, Rana Isguder
Objectives Transcobalamin II (TC) is an essential plasma protein for the absorption, transportation, and cellular uptake of cobalamin. TC deficiency presents in the first year of life with failure to thrive, hypotonia, lethargy, diarrhea, pallor, mucosal ulceration, anemia, pancytopenia, and agammaglobulinemia. Herein, we present TC deficiency diagnosed in two cases (twin siblings) with a novel variant in the TCN2 gene. Case presentation 4-month-old twins were admitted with fever, respiratory distress, vomiting, diarrhea, and failure to thrive...
August 25, 2020: Journal of Pediatric Endocrinology & Metabolism: JPEM
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