nystatin-a1 and Leukemia--Myeloid

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

Reverse isolation and prophylactic oral nonabsorbable antibiotics were evaluated among 64 consecutive noninfected adults with acute nonlymphocytic leukemia admitted for remission induction. Patients were randomly allocated to laminar air flow room reverse isolation with oral nonabsorbable antibiotics (LAF plus A), routine hospital ward care with antibiotics (W plus A), or ward care alone (W). The LAF plus A patients had a significantly decreased incidence of total infection, bacteremias, pneumonias, rectal abscesses, urinary tract infection, and pharyngitis. Infectious deaths were reduced in the LAF plus A group and the time to the first infection or to fatal infection was delayed. The W plus A patients who regularly ingested the antibiotics had a reduction in infections similar to that of the LAF plus A patients but those who could not tolerate the antibiotics had an incidence of infection comparable to the ward patients. The LAF plus A and the W plus A patients also had higher complete remission rates and longer median survival than the unprotected ward patients.

Topics: Acute Disease; Administration, Oral; Adult; Aged; Air Conditioning; Air Microbiology; Anti-Bacterial Agents; Bacterial Infections; Cross Infection; Environment, Controlled; Female; Gentamicins; Hospital Units; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Male; Middle Aged; Nystatin; Patient Isolators; Remission, Spontaneous; Urinary Tract Infections; Vancomycin; Ventilation; Virus Diseases

Faecal volatile fatty acids represent the end products of the metabolism of the anaerobic flora of the large bowel. The excretion of these volatile acids has been investigated in five leukaemic patients maintained in plastic ;germ-free' isolators. Under ;isolator' conditions there is a pronounced fall in volatile fatty acid excretion. The possibility that the measurement of these acids may be used to monitor anaerobic overgrowth and recolonization in these patients is discussed.

Topics: Adult; Chromatography, Gas; Colistin; Fatty Acids, Volatile; Feces; Female; Gentamicins; Humans; Intestine, Large; Leukemia, Monocytic, Acute; Leukemia, Myeloid; Leukemia, Myeloid, Acute; Male; Middle Aged; Nystatin; Patient Isolators; Propionates; Vancomycin

Topics: Adult; Amphotericin B; Candidiasis; Candidiasis, Oral; Esophageal Diseases; Fluoroscopy; Humans; Leukemia; Leukemia, Myeloid; Male; Middle Aged; Nystatin

Topics: Adult; Amphotericin B; Aspergillosis; Cytarabine; Female; Humans; Leukemia, Myeloid; Lung Diseases, Fungal; Nystatin; Pulmonary Embolism; Remission, Spontaneous

Topics: Acute Kidney Injury; Beverages; Erythromycin; Humans; Leukemia; Leukemia, Myeloid; Lung Abscess; Lung Diseases, Fungal; Methotrexate; Nystatin; Papilledema; Renal Insufficiency