Primary prophylaxis of invasive fungal infections in patients with haematological malignancies: 2017 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)
AbstractImmunocompromised patients are at high risk of invasive fungal infections (IFI), in particular those with haematological malignancies undergoing remission-induction chemotherapy for acute myeloid leukaemia (AML) or myelodysplastic syndrome (MDS) and recipients of allogeneic haematopoietic stem cell transplants (HSCT). Despite the development of new treatment options in the past decades, IFI remains a concern due to substantial morbidity and mortality in these patient populations. In addition, the increasing use of new immune modulating drugs in cancer therapy has opened an entirely new spectrum of at risk periods. Since the last edition of antifungal prophylaxis recommendations of the German Society for Haematology and Medical Oncology in 2014, seven clinical trials regarding antifungal prophylaxis in patients with haematological malignancies have been published, comprising 1227 patients. This update assesses the impact of this additional evidence and effective revisions. Our key recommendations are the following: prophylaxis should be performed with posaconazole delayed release tablets during remission induction chemotherapy for AML and MDS (AI). Posaconazole iv can be used when the oral route is contraindicated or not feasible. Intravenous liposomal amphotericin B did not significantly decrease IFI rates in acute lymphoblastic leukaemia (ALL) patients during induction chemotherapy, and there is poor evidence to recommend it for prophylaxis in these patients (CI). De...
A single administration of hyperthermic intraperitoneal chemotherapy at the end of cytoreductive surgery improves overall survival in women with advanced ovarian cancer.Medscape Medical News
Purpose: The transition from pediatric to adult medical services is an important time for an adolescent with a renal transplant. Failure to properly transition can lead to medical non-adherence and subsequent loss of graft and/or return to dialysis.
Purpose: Human Papilloma Virus (HPV) infection leads to 26,000 new genitourinary and oropharyngeal cancers yearly. Routine recommendation for HPV adolescent immunization was made in 2007 for girls and 2011 for boys. Although this series is efficacious, HPV vaccination rates remain low nationwide, especially when compared to other vaccines of the adolescent platform. Our Pediatric and Adolescent Medicine clinic is evaluating our current HPV vaccination rates with the goal to reach series completion in at least 80% of our adolescents 13 –17 years of age by the use of PDSA cycles.
Purpose: A 9-valent HPV vaccine that prevents HPV6, 11, 16, 18, 31, 33, 45, 52, and 58 was introduced in 2015. Clinical trials have demonstrated that the 9-valent as well as the 2-valent (HPV16, 18) and 4-valent (HPV6, 11, 16, 18) vaccines have high efficacy in preventing vaccine-targeted HPV types and associated pre-cancers, but surveillance studies are needed to examine the impact of vaccine introduction in community settings. The aims of this study were: 1) to assess vaccine effectiveness by determining the prevalence of 4- and 9-valent vaccine-type HPV in vaccinated young women, and 2) to assess herd protection by dete...
Purpose: Adolescent and young adult (AYA) kidney transplant (KT) recipients experience high rates of premature allograft loss. The healthcare transition (HCT) process is considered contributory. Yet, most AYA with KT navigate transition to adult care successfully, generating a critical need to identify protective factors associated with stable transition. Resilience is a learned and dynamic process with known positive impact on health outcomes. The purpose of this study is to explore the novel role of resilience as a protective factor in securing stable HCT in AYA with KT.
Purpose: Effective interventions to promote human papillomavirus (HPV) vaccination are needed, particularly among populations at greater risk of HPV-related disease. Gay and bisexual men have high rates of HPV infection and HPV-related disease, such as anal cancer, yet vaccination among young gay and bisexual men (YGBM) remains far below national guidelines. We developed and pilot tested a web-based intervention, Outsmart HPV, to promote HPV vaccination among YGBM.
(Reuters Health) - - A heated chemotherapy organ bath circulated throughout the abdomen after surgery can significantly prolong a woman's survival with advanced ovarian cancer, according to doctors testing the new treatment.
Read clinically focused news coverage of key developments from GICS 2018.Medscape Gastroenterology
BRCA1 methylation in normal tissue raises the risk for high-grade ovarian cancer and may occur before birth, according to a study from Norway.Reuters Health Information
Evaluation of biomarkers after 5 years of standard therapy for hormone-positive breast cancer may help determine those at risk for recurrence and those who may need further endocrine therapy.Medscape Oncology
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