Endoscopic Treatment and Pulmonary Rehabilitation for Management of Lung Abscess in Elderly Lymphoma Patients

Abstract

Background: The management of lung abscess may be a challenge in elderly patients undergoing chemotherapy and/or radiotherapy for previous malignancy. Herein, we reported a case series of elderly patients with previous lymphoma undergoing endoscopic treatment followed by pulmonary rehabilitation for lung abscess. Methods: Our study population included a consecutive series of elderly patients with previous lymphoma and lung abscess. Suppurative infection was refractory with specific antibiotic therapy. In all cases, drainage was endoscopically inserted in lung abscess via video-bronchoscopy. This strategy allowed performing daily therapy with the installation of gentamicin directly into the abscess cavity. All patients underwent a respiratory rehabilitation program to speed up convalescence and allow early discharge. Results: After positioning the catheter through a bronchoscopic route and subsequent washing with gentamicin, all the patients in our study showed an improvement in clinical conditions with resolution of fever within a few days of starting the procedure with normalization of blood tests (mean hospital length 7 ± 0.73 days). A follow-up chest computed tomography scan showed a resolution of lung abscess within a mean of 27 ± 1.53 days. Conclusions: Endoscopic treatment with a rehabilitation program may be a valuable strategy for the management of lung abscess that is refractory to standard antibiotic therapy. Further and larger studiesshould be done to confirm our results.

Primary Cutaneous B-Cell Lymphomas: An Update

“…This strategy consists of observing and treating the patient only when the disease shows systemic symptoms, bulky mass (<7 cm), symptomatic splenomegaly, progressive leukemization, and serum effusions. Follow-up is usually planned every 6 months with a complete skin and lymph node examination (17)(18)(19)(20)(21).…”

The impact of the SARS‐CoV‐2 infection, with special reference to the hematological setting

“…5 These example data, together with the data from few small other studies, suggest that the exposure of patients with cancer to SARS-CoV-2 is very risky, and that every possible precaution must be put in place to prevent this from happening. [6][7][8][9][10][11][12] These considerations also apply to the context of bone marrow transplantation. [13][14][15] We have prepared this review article for all doctors who have not had the opportunity to investigate the different aspects of COVID-19 sufficiently, including young infectious disease specialists, hematologists, and general practitioners, who for more than one reason may meet patients with COVID-19, having to make a first diagnosis and the first decisions about it.…”

An Anecdotal Case Report of Chronic Lymphatic Leukemia with del(11q) Treated with Ibrutinib: Artificial Nourishment and Physical Activity Program

“…The 2017 guidelines of the Italian Association of Medical Oncology (AIOM) recommend physical activity in neoplastic cachexia. It allows stabilization and recovery of muscle mass, promotes protein synthesis, reduces inflammatory response, and improves antioxidant activity, insulin resistance, immune status, cardiorespiratory and muscular fitness, and bone health [11][12][13][14][15]. Furthermore, physical activity might have a favorable impact on quality of life in elderly cancer survivors, increasing their physical abilities, avoiding depression, increasing their self-esteem, reducing the risk of cognitive decline, and promoting relaxation [14][15][16][17].…”

“…It is advisable to start with long walks, to increase progressively in rhythm and duration, accompanied by aerobic, upper and lower limb resistance training, and stretches [12]. Few data are available in the exercise program management in oncological and hematological setting and the lack of criteria for starting motor "muscle" rehabilitation, in particular in cachectic and elderly patients is reported [12][13][14][15][16][17][18][19][20][21]. Walter et al evaluated in the prospective VITamins and Lifestyle (VITAL) study on 364,418 oncological patients, aged 50-76 years, the impact of physical activity on hematologic malignancies; and observed the decreased risk of hematologic cancer associated with physical activity, in myeloid neoplasms, CLL/small lymphocytic lymphoma, and in other mature B-cell lymphomas [22].…”