Combination antifungals as an effective means of salvage in paediatric leukaemia patients with invasive fungal infections

Jagdish Prasad Meena, Aditya Kumar Gupta, Manisha Jana, Rachna SethIndian Journal of Medical Microbiology 2019 37(1):109-112 Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in paediatric leukaemias. Antifungal combinations to treat these patients are being explored. Fourteen children with leukaemias and IFIs were treated with a combination of antifungal agents at our centre. The first antifungal was amphotericin-B in 13 children and voriconazole in one child. In view of no improvement and clinical deterioration, in nine patients, voriconazole was added as the second antifungal agent and in four, it was caspofungin. All patients completed 4–6 weeks of antifungal therapy. The overall mortality attributable to IFI for the cohort was 4/14 (28%).
Source: Indian Journal of Medical Microbiology - Category: Microbiology Authors: Source Type: research

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AbstractWe performed a prospective multi-centre observational study to understand the incidence of IFI in patients with AML in India with use of anti-fungal prophylaxis. All patients with AML receiving either induction chemotherapy or salvage chemotherapy between November 2014 and February 2016 were included in this prospective observational study from 10 Indian centres. IFI was defined as per the revised EORTC-MSG criteria. Data on type of chemotherapy used, type of anti-fungal prophylaxis used, time to neutrophil recovery, incidence of IFI and survival were collected. Two hundred patients (118 male and 82 females) with a...
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research
Case: A 71-year-old male with acute myeloid leukemia (AML) on posaconazole for invasive fungal disease prophylaxis was found to have necrotic, escharred skin lesions on his bilateral forearms that developed while awaiting resolution of chemotherapy-induced neutropenia. 4-mm punch biopsies were performed through the necrotic center of each lesion and frozen sections were sent for investigation. Right forearm skin biopsy and frozen section were positive for angioinvasive fungal infection within the dermis and subcutis, which demonstrated vascular occlusion by numerous fungal hyphae.
Source: Journal of the American Academy of Dermatology - Category: Dermatology Source Type: research
Hematopoietic cell transplantation is an essential and often the sole treatment strategy for relapsed and refractory hematologic malignancies. Patients and health care professionals expect to achieve long-term survival with intensive chemotherapy, total body irradiation, and allogeneic immune reactions caused by the graft-versus-leukemia effect [1]. Controlling treatment-related mortality is also key to successful hematopoietic cell transplantation. Adverse events after hematopoietic cell transplantation include the immune reaction called graft-versus-host disease (GVHD); bacterial, viral, and fungal infections; and hepati...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
Hematopoietic cell transplantation is an essential and often the sole treatment strategy for relapsed and refractory hematological malignancies. Patients and health care professionals expect to achieve long-term survival with intensive chemotherapy, total body irradiation, and allogeneic immune reactions caused by graft versus leukemia effect [1]. Controlling treatment-related mortality is also a key to successful hematopoietic cell transplantation. Adverse events after hematopoietic cell transplantation include the immune reaction called graft versus host disease (GVHD), bacterial, viral, and fungal infections, and hepati...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Source Type: research
AbstractPatients with hematological malignancies are severely immunocompromised and are at high risk of invasive fungal infection (IFI), particularly those undergoing remission-induction chemotherapy for acute myeloid leukemia (AML). IFIs are a major cause of morbidity and mortality in such patients. We planned to study the incidence of IFI in patients with AML undergoing intensive chemotherapy and receiving antifungal prophylaxis. We retrospectively reviewed consecutive 46 patients with non-M3 AML, who received induction chemotherapy and systemic antifungal prophylaxis. None of the patients had IFI at the time of initiati...
Source: Indian Journal of Hematology and Blood Transfusion - Category: Hematology Source Type: research
Conclusion: The results indicate that oral candidiasis is a prevalent fungal infection in the patients with hematologic malignancies with C. albicans being the main etiological agent. However, other species of Candida cause similar infections in these patients. PMID: 31341565 [PubMed]
Source: Iranian Journal of Microbiology - Category: Microbiology Tags: Iran J Microbiol Source Type: research
Incorrect family name of Warissara Jutidamrongphan.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
This study aimed to investigate the effectiveness of oral VRCZ compared to that of first-generation azoles prescribed within 7  days after the onset of chemotherapy in adult patients with AML/MDS using the Japanese administrative database.MethodsThis nationwide retrospective cohort study was conducted using the Diagnosis Procedure Combination/Per-Diem Payment System. The primary outcome was the proportion of patients who switched to intravenous antifungal agents. Analyses using the instrumental variable method were performed to address unmeasured confounding.ResultsIn total, data on 5517 inpatients from 142 hospitals ...
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in children with cancer. An overview of studies on the frequency and determinants of IFI in pediatric oncology patients in nonallogeneic stem cell transplantation settings is lacking. We performed a literature review in Pubmed and Embase, and included 13 prospective and 23 retrospective studies. The IFI frequency (proven/probable based on EORTC criteria) in nonallogeneic stem cell transplantation pediatric cancer patients ranged between 1.0% and 38.0%, with the highest frequencies reported in hematologic malignancies. The most common fungal...
Source: Journal of Pediatric Hematology Oncology - Category: Hematology Tags: Review Articles Source Type: research
Source: Infection and Drug Resistance - Category: Infectious Diseases Tags: Infection and Drug Resistance Source Type: research
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