nystatin-a1 and Precursor-Cell-Lymphoblastic-Leukemia-Lymphoma

The goal of reducing oral complications during chemotherapy and bone marrow transplantation has received attention at several centers. The current randomized study of 86 adults with leukemia treated with chemotherapy or bone marrow transplantation assessed the potential role of chlorhexidine, nystatin, and saline solution rinses to reduce the findings of oral mucositis, gingivitis, and oral infection. The results of this study did not show a reduction in mucositis with the use of these rinses. However, potential bacterial and fungal pathogens were identified less frequently in the patients using chlorhexidine rinse.

Topics: Adolescent; Adult; Aged; Antineoplastic Agents; Bacteremia; Bacteria; Bone Marrow Transplantation; Candidiasis, Oral; Chlorhexidine; Drug Combinations; Female; Humans; Leukemia; Leukemia, Myeloid, Acute; Male; Middle Aged; Mouth Diseases; Mouthwashes; Nystatin; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Stomatitis; Ulcer; Whole-Body Irradiation

We undertook the present study to ascertain the contributing risk factors and explore the epidemiological and mycological characteristics of opportunistic candidemia among patients with hematological malignancies.. Observational cross-sectional study in a tertiary care center.. Consecutive patients with hematological malignancies reporting to the collaborating medical and pediatric units with a febrile episode were recruited and screened for candidemia by blood culture. Recovered Candida isolates were speciated and antifungal susceptibility testing was performed as per Clinical and Laboratory Standards Institute guideline (CLSI) guidelines M44-A. Further analysis was done for potential risk factors and compared between culture positive and negative patients.. Of 150 patients recruited, the majority (n=27) were between 51 and 60 years and the male to female ratio was 1.63:1. Fifteen patients (10%) were culture positive. The culture positivity was significantly higher in acute lymphocytic leukemia (ALL) than in non-ALL patients (p=0.03). There was significant association of candidaemia with leucopenia, chemotherapeutic drugs, corticosteroids and presence of indwelling devices. Duration of disease (p=0.032) and duration of hospitalization (p=0.003) were significantly prolonged in culture positive patients. C. tropicalis was the commonest isolate (46.67%), with non- Candida albicans outnumbering C. albicans in all categories of hematological malignancies (2.75:1). All isolates of C. albicans were uniformly sensitive to all the azoles, but only 50% were sensitive to amphotericin B and none to nystatin and flucytosine.. This observational study identifies ALL and chronic lymphocytic leukemia (CLL) as the forms of hematological malignancy predominantly associated with candidemia; specifies risk factors and chemotherapeutic agents predisposing patients towards its occurrence; reports a preponderance of C. tropicalis among the causative agents and finds voriconazole to be the most effective antifungal agent against the recovered isolates. This information could assist in tailoring prophylactic and therapeutic antifungal practices for this infection, according to local epidemiological and mycological characteristics.

Topics: Amphotericin B; Candida albicans; Candida tropicalis; Candidemia; Cross-Sectional Studies; Female; Hematologic Neoplasms; Humans; India; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Middle Aged; Nystatin; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Prevalence; Risk Factors; Tertiary Care Centers; Voriconazole

The dental condition of 54 children aged 3-19 years who were in remission from acute lymphoblastic leukaemia was examined in relation to the duration of their chemotherapy and their period of time in remission. There were no significant differences in the number of early ('white spot') lesions or in the total dental caries experience in relation to the duration of chemotherapy. Children who were longest in remission had significantly more white spot lesions in permanent teeth but not in primary teeth, and there was no significant difference in dental caries experience. Children who had received nystatin treatment for more than a year had significantly more white spot lesions in permanent teeth than those who had received nystatin for shorter periods.

Topics: Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents; Child; Dental Care for Chronically Ill; Dental Caries; Dentition, Permanent; DMF Index; Humans; Nystatin; Pharmaceutical Vehicles; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Statistics, Nonparametric; Time Factors; Tooth, Deciduous