nystatin-a1 and Leukemia--Lymphoid

Topics: Bacterial Infections; Clinical Trials as Topic; Drug Evaluation; Drug Therapy, Combination; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Nystatin; Sulfamethoxazole; Trimethoprim

30 patients with acute leukaemia being treated with cytotoxic drugs were investigated in a randomised trial to determine whether oral administration of co-trimoxazole in addition to non-absorbable antibiotics would reduce the rate of infection. Three significant differences were observed between the co-trmoxazole and the control groups: (i) 15 of the 16 (94%) control patients but only 8 of the 14 (57%) patients on co-trimoxazole developed infections and required additional antibiotics intravenously; (ii) although the duration of severe neutropenia (neutrophils less than 0.1 times 10(9)/1) was similar in the two groups, control patients required intravenous antibiotics on average after 2 days of neutropenia, whereas patients receiving co-trimoxazole required these only after 12 days; and (iii) the only 2 patients who died of infection were in the control group. Prophylaxis with co-trimoxazole is important in preventing or delaying the development of infection in neutropenic patients receiving therapy for acute leukaemia.

Topics: Administration, Oral; Adolescent; Adult; Aged; Clinical Trials as Topic; Colistin; Cross Infection; Drug Combinations; Drug Therapy, Combination; Framycetin; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Middle Aged; Neutropenia; Nystatin; Prospective Studies; Research Design; Sulfamethoxazole; Trimethoprim

Fifty-six untreated patients with acute leukemia (38 acute myelogenous leukemia, 16 acute lymphoblastic leukemia, and 2 blast crisis of chronic granulocytic leukemia) were randomized on admission to one of three groups--one to receive oral anticandidal prophylaxis through the period of remission induction chemotherapy with nystatin, another to receive natamycin, and the third to receive no anticandidal prophylaxis. Neither of the first two groups show any advantage over the last and it is concluded that provided gut sterilization regimes are not employed, prophylactic oral anticandidal treatment is of no value in these patients and should be reserved until there is clinical evidence of infection.

Topics: Administration, Oral; Antineoplastic Agents; Candidiasis; Candidiasis, Oral; Drug Evaluation; Humans; Leukemia, Lymphoid; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Natamycin; Nystatin

The synthesis and evaluation of some 2-substituted-1,4-naphthoquinones 2, S-(1,4-naphthoquinon-2-yl)-mercaptoalkanoic acid amides 4, related benzoquinone and naphthoquinone derivatives 6-9 and 2,3-disubstituted 1,4-naphthoquinones 10-11 were carried out. The antifungal, antibacterial, antiviral and anticancer activities were determined by using the standard assay. The results show that compounds 2b and 10a showed in vitro antiviral activity against Influenza-A Virus and Herpes Simplex Virus and possess pronounced antifungal profile whereas 4a showed anticancer activities against Lymphoid Leukaemia P 388.

Topics: Animals; Anti-Infective Agents; Antineoplastic Agents; Cell Line, Tumor; Cell Survival; Influenza A virus; Leukemia, Lymphoid; Mice; Microbial Sensitivity Tests; Naphthoquinones; Simplexvirus; Structure-Activity Relationship

Topics: Amphotericin B; Candidiasis, Cutaneous; Candidiasis, Oral; Child; Esophagitis; Female; Humans; Ketoconazole; Leukemia, Lymphoid; Male; Nystatin; Thrombocytopenia

Allogeneic bone marrow transplantations were carried out between March 1983 and July 1985 in 31 patients aged 7 to 45 years (median 18 years). Acute lymphoblastic leukaemia in 1st to 5th remission was present in 8 patients, acute myeloblastic leukaemia in 1st and 2nd remission in 4 patients, chronic myeloid leukaemia, with various remission status, in 6 patients, 3 patients had severe aplastic anaemia and there were single cases of myelodysplasia and immature cell megakaryocytic myelosis. Transplantation was carried out during relapse in 8 patients with either acute myeloid or lymphoblastic leukaemia. Phenotypic HLA-identical mothers (n = 2) as well as genotypic HLA-identical siblings (n = 27), and in two cases HLA-non-identical mothers, served as bone marrow donors. In leukaemia patients the conditioning treatment consisted of fractionated total body irradiation and high dose cyclophosphamide or etoposide. Patients with severe aplastic anaemia received cyclophosphamide (4 X 50 mg/kg) and fractionated total nodal irradiation (total dose 8 Gy). 19 patients (61%) survived 14 to 605 days after bone marrow transplantation. 15 patients (48%) continue to remain in complete remission with Karnofsky indices of greater than or equal to 90%. Causes for death were infection (n = 3), interstitial pneumonia (n = 3), relapse (n = 3) as well as single cases involving acute graft-versus-host-disease, non-engraftment of donor marrow and veno-occlusive disease of the liver.

Topics: Acyclovir; Adolescent; Adult; Amphotericin B; Anemia, Aplastic; Bone Marrow Transplantation; Child; Cyclophosphamide; Etoposide; Female; Graft Survival; Graft vs Host Disease; Herpes Genitalis; HLA Antigens; Humans; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Male; Methotrexate; Middle Aged; Nystatin; Prednisolone; Tissue Donors; Whole-Body Irradiation

The effect of a multi-agent regimen on oropharyngeal candidiasis (OPC) prophylaxis in 16 consecutive pediatric bone marrow transplant patients was assessed. The multi-agent regimen consisted of: 1) debriding all mucous membrane surfaces within the oropharyngeal cavity with povidone-iodine 4 times a day, 2) swabbing all mucous membrane surfaces within the oropharyngeal cavity with nystatin 4 times a day, and 3) Ketoconazole given daily by mouth. Multi-agent regimen therapy was initiated on the day marrow ablative therapy began, and was terminated when the patient's absolute neutrophil count recovered to above 500/mm3. Baseline oropharyngeal fungal cultures indicated that 8 out of 16 (50%) of the patients were Candida carriers. Subsequent surveillance cultures indicated that 13 out of 16 (81.3%) of the patients had negative oropharyngeal fungal cultures during the entire period they were on the multi-agent regimen. The remaining three patients had negative oropharyngeal fungal cultures by the end of the experimental period. None of the patients developed Candida esophagitis or sepsis. The above regimen is an effective and non-toxic method to prevent oropharyngeal candidiasis in pediatric BMT patients.

Topics: Adolescent; Anemia, Aplastic; Bone Marrow Transplantation; Burkitt Lymphoma; Candidiasis; Child; Child, Preschool; Female; Humans; Infant; Ketoconazole; Leukemia; Leukemia, Lymphoid; Male; Mouth Diseases; Neuroblastoma; Nystatin; Pharyngeal Diseases; Povidone-Iodine; Transplantation, Autologous; Transplantation, Homologous

Ninety-three hospitalizations of 70 patients, who underwent induction chemotherapy for acute leukemia to determine the effectiveness of oral nystatin in preventing oropharyngeal and systemic candidiasis were reviewed. Sixty-two percent of patients who received prophylactic nystatin and 58% of patients who did not receive nystatin developed oropharyngeal candidiasis; 11% of patients who received prophylaxis and 21% of those who did not receive prophylaxis developed systemic candidiasis. The use of oral nystatin did not significantly diminish the risk of developing either type of Candida infection. Oropharyngeal candidiasis occurred more commonly in patients who had severe and prolonged leukopenia, had received more parenteral antibiotics, and had developed chemotherapy-induced mucositis. Systemic candidiasis developed almost exclusively in patients who had prior oropharyngeal candidiasis. Guidelines for the empiric use of amphotericin B in these patients are provided.

Topics: Administration, Oral; Adult; Candidiasis; Candidiasis, Oral; Female; Humans; Leukemia; Leukemia, Lymphoid; Male; Nystatin

Topics: Candidiasis; Child; Child, Preschool; Female; Humans; Infant; Leukemia, Lymphoid; Male; Nystatin

Topics: Adrenal Cortex Hormones; Bacitracin; Blood Transfusion; Calcium; Digitalis Glycosides; Diuretics; Humans; Hypocalcemia; Leukemia; Leukemia, Lymphoid; Leukemia, Myeloid, Acute; Neomycin; Nystatin; Potassium; Retrospective Studies; Serum Albumin; Tetany