mercaptopurine and Bacterial-Infections

Topics: Adolescent; Adult; Asparaginase; B-Lymphocytes; Bacterial Infections; Child; Child, Preschool; Chromosome Aberrations; Chromosome Disorders; Diagnosis, Differential; Drug Therapy, Combination; Female; Humans; Infant; Leukemia; Leukemia, Lymphoid; Leukocyte Count; Male; Meningeal Neoplasms; Mercaptopurine; Methotrexate; Prednisolone; T-Lymphocytes; Testicular Neoplasms; Vincristine

Topics: Asparaginase; Bacterial Infections; Central Nervous System Diseases; Child; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Synergism; Hemorrhage; Humans; Immunotherapy; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Mitosis; Neoplasms, Nerve Tissue; Prednisone; Remission, Spontaneous; Testicular Neoplasms; Uric Acid; Vincristine

Although cure rates in pediatric acute lymphoblastic leukemia (ALL) are quite high with combined chemotherapy regimens, complete response (CR) and long-term survival rates in adults are 80-90 and 30-40%, respectively. Currently, combined chemotherapy regimens, such as Hyper-CVAD and PETHEMA, are used in patients with adult ALL. However, there has been no study comparing the results of Hyper-CVAD and PETHEMA ALL-93.. In this retrospective single-center study, we evaluated the results of Hyper-CVAD and PETHEMA ALL-93 in 51 ALL patients treated between September 2008 and March 2017 at the Department of Hematology, Faculty of Medicine, Karadeniz Technical University.. Thirty-eight patients were treated with Hyper-CVAD and 13 with PETHEMA ALL-93. CR was obtained in 90 and 100% of patients, respectively. Survival estimates were comparable between Hyper-CVAD and PE-THEMA ALL-93, with a median overall survival (OS) and a median disease-free survival (DFS) of 17.5 and 12.1 months, respectively, for Hyper-CVAD and of 18.6 and 12.9 months, respectively, for PETHEMA ALL-93. The 2-year OS rates for Hyper-CVAD and PETHEMA ALL-93 were 30 and 40%, respectively, and the 2-year DFS rates were 28 and 44%, respectively. PETHEMA ALL-93 resulted in more hepatotoxicity, hypofibrinogenemia, aspergillus infection, and skin rash than Hyper-CVAD.. Although Hyper-CVAD and PE-THEMA ALL-93 showed similar effects, Hyper-CVAD was tolerated better. Age and comorbidities should be taken into account before a chemotherapy regimen is determined for patients with ALL.

Topics: Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bacterial Infections; Cyclophosphamide; Dexamethasone; Disease-Free Survival; Doxorubicin; Female; Fever; Humans; Male; Mercaptopurine; Methotrexate; Middle Aged; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Retrospective Studies; Survival Rate; Treatment Outcome; Vincristine; Young Adult

Topics: Adolescent; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bacterial Infections; Child, Preschool; Cyclophosphamide; Cytarabine; Daunorubicin; Encephalitis, Herpes Simplex; Fatal Outcome; Female; Hematopoietic Stem Cell Transplantation; Herpes Simplex; Humans; Induction Chemotherapy; Infant; Male; Mercaptopurine; Methotrexate; Opportunistic Infections; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Simplexvirus; Stomatitis, Herpetic; Vincristine; Virus Activation

Modified BFM-90 regimen has significantly improved the outcome of lymphoblastic lymphoma in children and adolescents. Infection is the main side effect of this regimen, which may affect the treatment efficacy and prognosis without proper intervention. This study was to summarize the characteristics of the modified BFM-90 regimen related infection, and explore effective approaches to treat the infection.. The infection rate, site, pathogen were reviewed for the infections of 104 children and adolescents suffering from lymphoblastic lymphoma at different phases of the modified BFM-90 regimen. The relationship between chemotherapy, bone marrow suppression and infection was analyzed. The value of procalcitonin (PCT) in identifying the infection type and the outcome of anti-infection treatment was evaluated.. The infection rates in reduction phases Ia, Ib and re-reduction phases IIa, IIb were 52.5%, 60.7% and 48.6%, 28.2%, respectively. The infection rate in consolidation chemotherapy for patients with low to intermediate risk and high risk were 17.2% and 100%, respectively. In total 302 infections occurred. One hundred and sixty-seven cases (55.3%) had documented infection sites, most of which happened to the respiratory tract. Ninety-five cases (31.5%) had documented pathogens, most of which were Gram-negative bacteria. Infections of 262 cases (86.8%) were secondary to bone marrow suppression. The sensitivity and specificity of PCT in diagnosing sepsis were 83.3% and 70.2%, but it failed to identify the infection type. After the anti-infection treatment, 296 cases were cured, four cases gave up further treatment due to financial difficulties, two cases died of sepsis.. Infections caused by modified BFM-90 regimen for lymphoblastic lymphoma in children and adolescents are closely correlated to bone marrow suppression. The positive diagnosis rate of the pathogen is too low to identify most of the infection type. The treatment still mainly depends on experience.

Topics: Adolescent; Anti-Bacterial Agents; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bacterial Infections; Cephalosporins; Child; Child, Preschool; Cross Infection; Cyclophosphamide; Cytarabine; Daunorubicin; Disease Progression; Female; Humans; Itraconazole; Male; Mercaptopurine; Methotrexate; Mouth Diseases; Mycoses; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisone; Recurrence; Remission Induction; Respiratory Tract Infections; Vincristine

Thirty-four children with diagnosed cases of acute leukemias and being treated with cytotoxic chemotherapy at St James' Hospital, Leeds, were followed for between 6 months and 1 year to determine the changes in their oral microflora. They were examined before treatment commenced and then at monthly intervals. Swabs were taken from the oral cavity to test for the presence or absence of bacteria and Candida. Saliva samples were also used to assess the levels of Streptococcus mutans in the mouth. Sensitivity tests were carried out to assess the effect of the cytotoxic agents on the oral flora. All children received prophylactic nystatin and chlorhexidine gluconate mouthrinses four times daily for the whole period of the study. There was significant difference (p < 0.0001) for counts of S. mutans at different treatment stages. Sensitivity tests showed that S. mutans was sensitive to the cytotoxic drug daunorubicin, and this drug was probably responsible for the fall in S. mutans counts. A significant difference was also found in the types of bacteria isolated between the study and reference groups, but there was no change in the composition of the flora in the study group during treatment. These bacteria were also found to mirror those cultured from routine blood samples in children with acute leukemia.

Topics: Adolescent; Analysis of Variance; Anti-Bacterial Agents; Antifungal Agents; Antineoplastic Combined Chemotherapy Protocols; Asparaginase; Bacterial Infections; Candida albicans; Candidiasis, Oral; Chi-Square Distribution; Child; Child, Preschool; Chlorhexidine; Colony Count, Microbial; Cytarabine; Daunorubicin; Etoposide; Female; Gram-Negative Bacteria; Gram-Positive Bacteria; Humans; Infant; Leukemia, Myeloid, Acute; Male; Mercaptopurine; Methotrexate; Mouth; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prednisolone; Streptococcus mutans; Thioguanine; Trimethoprim, Sulfamethoxazole Drug Combination; Vincristine

Topics: Adolescent; Adrenal Cortex Hormones; Asparaginase; Bacterial Infections; Child; Child, Preschool; Colistin; Cyclophosphamide; Cytarabine; Daunorubicin; Drug Therapy, Combination; Female; Humans; Infant; Injections, Spinal; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Remission, Spontaneous; Skull; Vincristine

The criteria for false positivity of the NBT test were described including absence of classical clinical signs of bacterial infection, negative blood (and, if necessary, other) cultures, and lack of response of antibacterial treatment as the basis for appreciation of positive NBT test result as false-positive. A case of acute lymphoblastic leukaemia with all the criteria being fulfilled was described.

Topics: Adult; Bacterial Infections; Cyclophosphamide; False Positive Reactions; Female; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Nitroblue Tetrazolium; Recurrence; Remission, Spontaneous; Sulfamethoxazole; Tetrazolium Salts; Trimethoprim; Vincristine

The quality of life in leukaemia is as important as its quantity. In fifty-one patients the quality and quantity of life were improved by less aggressive treatment than is usual. By not trying to induce complete remission at all costs, the mobidity and early mortality were reduced and at least an equivalence in survival was obtained.

Topics: Acute Disease; Adolescent; Adult; Aged; Allopurinol; Bacterial Infections; Cytarabine; Daunorubicin; Drug Therapy, Combination; Focal Infection, Dental; Follow-Up Studies; Humans; Length of Stay; Leukemia, Myeloid, Acute; Mercaptopurine; Middle Aged; Philosophy; Quality of Life; Remission, Spontaneous

Topics: Animals; Antigens; Bacterial Infections; Escherichia coli; Female; Immunity; Immunization; Male; Mercaptopurine; Mice; Muramidase

Topics: Animals; Bacterial Infections; Body Weight; Female; Immunity; Leukocytes; Male; Mercaptopurine; Mice; Mortality; Reticulocytes

Long-term immunosuppressive therapy of mice with 6-mercaptopurine (6-MP) for 2 and/or 3 weeks results in partial lethality, decrease of total leukocyte count, of serum lysozyme level and in bacteremia. The adverse effect of 6-MP treatment could not be prevented by lysozyme administration; immunization with Escherichia coli O86 antigen further increased the lethality of 6-MP in mice. The results stress the potential danger of immunization with bacterial antigens during immunosuppressive therapy.

Topics: Animals; Antigens, Bacterial; Bacterial Infections; Blood; Body Weight; Enterobacteriaceae; Escherichia coli; Female; Immunization; Immunosuppressive Agents; Injections, Intraperitoneal; Leukocyte Count; Male; Mercaptopurine; Mice; Muramidase; Proteus

Infections in the immunosuppressed cancer patient are caused by a wide variety of bacteria, viruses, fungi, and protozoa; many of these in the normal individual are saprophytes but will cause disease in the immunosuppressed patient, often with treatment failure. Patterns of infection are recognized, and this should enable the physician to plan a meaningful course of action when infection occurs in the compromised host. Obviously, it would be much better to prevent rather than have to treat infection in these immunosuppressed patients. Ideally, in the future, it is hoped that drugs which have less suppressive effect on defense mechanisms will provide a partial solution to the problem of infection in the immunosuppressed patient.

Topics: Adrenal Cortex Hormones; Alkylating Agents; Antineoplastic Agents; Azathioprine; Bacteria; Bacterial Infections; Folic Acid Antagonists; Humans; Immunity, Cellular; Immunosuppression Therapy; Immunosuppressive Agents; Infections; Lymphocytes; Mercaptopurine; Mycoses; Neoplasms; Phagocytosis; Protozoan Infections; Virus Diseases

Topics: Adolescent; Bacterial Infections; Central Nervous System Diseases; Chicago; Child; Child, Preschool; Cyclophosphamide; Female; Follow-Up Studies; Humans; Leukemia, Lymphoid; Male; Mercaptopurine; Methotrexate; Prednisone; Vincristine