Eight patients with progressive multiple myeloma were given an intermediate intravenous dose of melphalan (30 mg/m2). A response lasting 2–18 months was observed in 7 patients. The bone marrow toxicity was well acceptable and most courses could be given on an outpatient basis. Intermediate-dose intravenous melphalan may be considered an alternative for treatment of relapsing or progressive multiple myeloma, even if the patient has previously received oral melphalan.
In this Swedish multicentre study we compared the efficacy of meropenem with ceftazidime for treatment of febrile neutropenia. 192 patients were randomized and the number of evaluable patients was 92 in the meropenem group and 95 in the ceftazidime group. 40 (43%) patients in the meropenem arm and 49 (52%) in the ceftazidime arm had acute leukaemia. 56 (61%) and 52 (55%) patients respectively had a neutrophil count of < 0.1 x 10(9)/l at randomization and the median duration of neutropenia was 6.5 and 8 d, respectively. Thirty-one (34%) and 28 (29%) patients had a microbiologically defined infection, 14 (15%) and 17 (18%) a clinically defined infection and the remaining 47 (51%) and 50 (53%) had unexplained fever. After 72 h of treatment, 46 (50%) patients in the meropenem arm and 53 (56%) patients in the ceftazidime arm were alive on unmodified monotherapy. 42 (46%) and 47 (49%) of these completed the study on monotherapy alone. Only 2 patients (2%) in each arm had to stop treatment owing to allergic reactions. None of the observed differences were statistically significant and we therefore conclude that meropenem was an effective and safe alternative to ceftazidime for empiric treatment of fever during neutropenia.
Abstract. Seventy splenectomized patients were vaccinated with Pneumovax®, a pneumococcal polysaccharide vaccine. Twenty‐four of the patients had a malignant and 30 a non‐malignant hematological disorder. The remaining 16 were patients with no known hematological disorder, seven with intra‐abdominal carcinomas and nine with non‐malignant reasons for splenectomy. About 90% of the patients with non‐malignant hematological disorders responded to vaccination with a rise in antibody titres, which was significantly higher than in the other two groups studied. Malignant hematological disorders lowered the response rate to 61–67%. Patients with no known hematological disorder but with intraabdominal carcinomas also responded less frequently, while those in this group with other surgical reasons for splenectomy had a response rate comparable to healthy individuals. No serious side‐effects were reported and we therefore conclude that all splenectomized patients should be vaccinated with a pneumococcal vaccine. However, it must always be born in mind that one third of the patients with malignant disease did not respond to vaccination.
Summary: We present three patients with hematological malignancies, all neutropenic and febrile despite broadspectrum antibiotics. They all developed a sparse rash with purpuric maculopapules with a violaceous hue centrally. These skin lesions were associated with systemic Candida infections and responded well to antifungal treatment. They appeared to be a short‐cut to the diagnosis of systemic Candida infections for both the hematologist and the dermatologist. Zusammenfassung: Wir stellen drei Patienten mit malignen hämatologischen Krankheiten vor; sämtliche hatten eine Neutropenie und trotz Breitbandantibiotika Fieber. Alle entwickelten ein diskretes Exanthem mit juckenden Makulopapeln mit zentraler Violettfärbung. Diese Hauteffloreszensen waren mit systemischen Candidosen assoziiert und sprachen gut auf antimykotische Therapie an. Sie scheinen ein diagnostischer Hinweis für den Hämatologen wie für den Dermatologen auf das Vorliegen einer systemischen Candidose zu sein.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.