Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis.
Minimal Cerebrospinal Concentration of Miltefosine Despite Therapeutic Plasma Levels During the Treatment of Amebic Encephalitis. Antimicrob Agents Chemother. 2019 Nov 04;: Authors: Monogue ML, Watson D, Alexander JS, Cavuoti D, Doyle LM, Wang MZ, Prokesch BC Abstract Miltefosine is an alkylphosphocholine compound used primarily for treatment of leishmaniasis that also demonstrates in vitro and in vivo anti-amebic activity against Acanthamoeba species. As such, recommendations for treatment of amebic encephalitis generally include miltefosine therapy. Data supports a minimum amebicidal concentration of at least 16 mcg/mL is required for most Acanthamoeba species. Although there is a high level of mortality associated with amebic encephalitis, a paucity of data regarding miltefosine levels in the plasma and cerebrospinal fluid in vivo exists in the literature. We found that despite aggressive dosing (miltefosine 50 mg orally every 6 hours) and therapeutic plasma levels, cerebrospinal fluid miltefosine concentration was negligible in a patient with Acquired Immunodeficiency Syndrome (AIDS) and Acanthamoeba encephalitis. PMID: 31685474 [PubMed - as supplied by publisher]
Authors: Lanzafame M, Lattuada E, Vincenzi M, Vecchi M, Luise D, Diani E, Gibellini D PMID: 31809663 [PubMed - as supplied by publisher]
In conclusion, favorable-risk cytogenetics may improve the clinical outcomes of patients with FLT3-ITD-mutated AML, but adverse-risk cytogenetics may not further worsen the prognosis. Sorafenib combined with chemotherapy may increase the ORR but would not result in a longer OS and RFS. PMID: 31807186 [PubMed]
Authors: Gao M, Pang H, Kim YM, Lu X, Wang X, Lee J, Wang M, Meng F, Li S Abstract Translocation (9;11)(p21.3;q23.3) is one of the most common lysine methyltransferase 2A (KMT2A)-rearrangements in de novo and therapy-related acute myeloid leukemia (AML). Numerous in vitro and in vivo studies have demonstrated that the KMT2A/MLLT3 super elongation complex subunit (MLLT3) fusion gene on the derivative chromosome 11 serves a crucial role in leukemogenesis. Trisomy 9 as a secondary chromosome change in patients with t(9;11) is relatively rare. The present study reported a unique case of AML with a chromosome 9 trisomy ...
Authors: Ding Y, Ding K, Yu K, Zou D, Yang H, He X, Mo W, Yu X, Ding X Abstract The 2010 American Society of Clinical Oncology guidelines have reduced the immunohistochemistry cut-off value for determining estrogen receptor b positivity from 10 to 1% of stained cells in breast cancer. In clinical practice, low-hormone receptor positive (low HR+) tumors are classified in the luminal subtype, although they exhibit aggressive features and poor prognosis. Information regarding the prognosis of patients with breast cancer following treatment with optimal endocrine therapy and neoadjuvant chemotherapy (NAC) is currently ...
Authors: Zhang C, Xiong X, Li Y, Huang K, Liu L, Peng X, Weng W Abstract Neuroblastoma (NB) is one of the most common extracranial, solid, pediatric malignancies. Despite improvements in conventional therapies, including surgery, chemotherapy and radiation therapy, the prognosis of stage IV NB remains poor, indicating that novel treatment strategies are required. Immunotherapies, such as anti-GD2 monoclonal antibodies, used alone or in combination with cytokines, and peripheral blood mononuclear cells or cord blood mononuclear cells (CBMNCs), have been indicated to cause NB cell death and to prolong patient surviva...
In this study, we report the occurrence of the Acanthamoeba belonging to the T4 genotype isolated from nasal and oral swabs of a 15-yr-old man with HIV infection. HIV was confirmed using ELISA kit and RT-PCR assay. The isolated strain showed pathogenic potential using thermo and osmotolerance assays. This patient might be vulnerable to develop GAE or disseminated infections and depending on the immunologic status of the patient, this could be a health threat. Monitoring of such patients, appropriate diagnostic procedures and improved-HIV related care can alter the outcome of such infections. PMID: 28761472 [PubMed]
Conclusion This is the first report of a patient with AIDS and granulomatous amebic encephalitis who survived with medical therapy only.
We describe a case of fatal granulomatous amoebic encephalitis in a patient recently diagnosed to be having SLE, who was receiving corticosteroids, cyclophosphamide, methotrexate, and hydroxychloroquine. The patient presented in an altered sensorium and expired after being hospitalized for 6 days. Postmortem examination of the brain showed extensive areas of necrosis and neutrophilic infiltrate with trophozoites and cysts of Acanthamoeba.
We report a patient in whom GAE secondary to Acanthamoeba was the initial presentation of acquired immunodeficiency syndrome in a 41‐year‐old male, and discuss the FDG positron emission tomography (PET) and magnetic resonance imaging findings that preceded the pathological diagnosis. The PET results provided complementary information when coupled with the MR brain findings. Improved understanding of the clinical and imaging findings of this deadly disease is the best hope for early diagnosis and treatment of this uncommon but deadly disease.