Infectious complications in patients with acute myeloid leukemia treated according to the protocol with daunorubicin and cytarabine with or without addition of cladribine. A multicenter study by the Polish Adult Leukemia Group (PALG)

Lech-Maranda, Ewa; Seweryn, Marek; Giebel, Sebastian; Hołowiecki, Jerzy; Piątkowska−Jakubas, Beata; Węgrzyn, Joanna; Skotnicki, Aleksander B.; Kiełbiński, Marek; Kuliczkowski, Kazimierz; Paluszewska, Monika; Jędrzejczak, Wiesław Wiktor; Dutka, Magdalena; Hellmann, Andrzej; Flont, M; Zdziarska, Barbara; Pałynyczko, G.; Konopka, L; Szpila, Tomasz; Gawroński, Krzysztof; Sułek, K; Sokołowski, Jarosław; Kłoczko, Janusz; Warzocha, Krzysztof; Robak, Tadeusz

doi:10.1016/j.ijid.2009.02.021

Cited by 34 publications

(33 citation statements)

References 35 publications

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“…In recent years, an increase in gram-positive bacteria like Methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci (CNS) has been noted [1][2][3]. With regard to pneumonia, the relative frequency among febrile neutropenic episodes ranges between 10 and 30%, and reported mortality range between 20 and more than 60% [1,[4][5][6]. Although the etiology of pneumonia in neutropenic patients can be defined in only 10-45%, an increase of filamentous fungi such as Aspergillus spp.…”

Section: Introductionmentioning

confidence: 99%

Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group

et al. 2011

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We analyzed the incidence and prognosis of bacteremia/fungemia and pneumonia during remission induction therapy of a newly diagnosed acute myelogenous leukemia (AML) in the Japan Adult Leukemia Study Group treated with individual protocols of AML-87/-89 (1987-1991), AML-92 (1992-1995), AML-95 (1995-1997), and AML-97 (1997-2001). Bacteremia/fungemia was present in 251 of 2585 cases (9.7%); the causative microorganism was gram-positive bacteria (GPB) in 122 cases (49%), gram-negative bacteria (GNB) in 90 cases (36%), fungi (F) in 31 cases (12%), and polymicrobes (P) in 8 cases (3%). Particularly prevalent were Pseudomonas aeruginosa in 49 cases (20%), Staphylococcus epidermidis in 29 cases (12%), and Staphylococcus aureus in 25 cases (10%). With AML-87/-89, incidence of bacteremia/fungemia was 11.8% while it was 9.4% with AML-92, 8.7% with AML-95, and 9.2% with AML-97. The proportion of GPB, GNB, F, and P was 40, 41, 16, and 3% in AML-87/-89, 46, 40, 11, and 3% in AML-92, 48, 39, 11, and 2% in AML-95, and 59, 26, 11, and 4% in AML-97. The mortality rate by period was 26.5, 16.4, 14.0, and 6.8%, respectively. Pneumonia was found in 433 cases (16.8%); microbiological research covered 359 cases of AML-87/-89, AML-92, AML-97 and excluded AML-95 as there was no listing for the causative microorganism on questionnaires. Microbiologically documented pneumonia was found in 123 cases (34.3%), with GPB in 33 cases (27%), GNB in 28 cases (23%), F in 44 cases (36%), and P in 18 cases (15%); particularly prevalent were Aspergillus in 23 cases (19%), Staphylococcus aureus in 16 cases (13%), and Pseudomonas aeruginosa in 15 cases (12%). The incidence of pneumonia overall was 24.6% with AML-87/-89, 16.9% with AML-92, 13.9% with AML-95, and 12.9% with AML-97, with a mortality rate of 28.9, 33.3, 16.7, and 16.7%, respectively. Incidence of bacteremia/fungemia and pneumonia complicating AML has tended to decline in recent years, and mortality has also tended to improve.

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Section: Introductionmentioning

confidence: 99%

Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group

et al. 2011

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“…More recently studied dosing schemes have been essentially devoid of the neurotoxicity that plagued early studies with high dose, CIVI regimens. In theory, use of CdA may predispose patients to a greater risk of OIs however, such data is largely limited to patients with lymphoid malignancies and does not appear to be a complication of CdA combination regimens for AML [74].…”

Section: Discussionmentioning

confidence: 99%

“…No difference was found in the incidence of fever related to infection, fever of unknown origin, or grade 3/4 documented infections. Moreover, no differences in pathogen distribution or infection related mortality were reported [74]. Of note, culture-negative fever is common in patients receiving CdA for various conditions.…”

Section: Safety and Tolerability Of Cladribine In Amlmentioning

confidence: 96%

“…Although the most commonly reported OI is herpes simplex, constituting about 50% of reported OIs in CdA treated patients with lymphoma, acute leukemia, and chronic leukemia, pneumocystis, toxoplasmosis, herpes zoster, cytomegalovirus, and disseminated fungal infections have all been reported following treatment with CdA for a variety of conditions [72,73]. Taking note of such concerns, the PALG compared infectious complications following DAC and DA induction for AML [74]. The addition of CdA to DA did not prolong neutropenia (days with ANC <1,000/mL: 18 days with DAC, 19 days with DA), although patients receiving DAC did have a lower absolute lymphocyte count at infection onset (500/mL vs. 660/mL, P 5 0.007).…”

Section: Safety and Tolerability Of Cladribine In Amlmentioning

confidence: 99%

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Revisiting the role of cladribine in acute myeloid leukemia: An improvement on past accomplishments or more old news?

et al. 2014

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Originally studied in lymphoid diseases, cladribine (CdA) is an adenosine deaminase resistant analog of adenosine that was later discovered to induce myeloid cell apoptosis. The activity of CdA in myeloid malignancies was first reported in relapsed/refractory (RR) pediatric acute myeloid leukemia (AML) with complete response (CR) rates of up to 47%. Consequently, several studies have confirmed the efficacy of single agent CdA or CdA combination regimens in AML. Established CR rates for combination regimens in RR adults are approximately 50%, while CR rates for newly diagnosed (ND) adults are approximately 70% and show similar toxicity profiles to previously used regimens. Despite these promising data, many centers have yet to adopt CdA combination regimens for these difficult to treat populations. We review the pharmacology, pharmacokinetics, clinical data, and safety of CdA monotherapy and combination regimens for the management of pediatric and adult ND and RR-AML.

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“…The patients with acute leukemia are at high risk for infections complications (Hirotsu and Akatsuka 1991 ;Maranda et al 2010 ) . Serious, life threatening infections remain a major cause of morbidity and mortality in this group of patients.…”

Section: Nets In Neoplasm Of Developmental Agementioning

confidence: 99%

Neutrophil Extracellular Trap in Human Diseases

Araźna

Pruchniak

Życińska

et al. 2012

Advances in Experimental Medicine and Biology

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NETosis is a unique death pathway that differs from apoptosis and necrosis and depends on the generation of reactive oxygen species (ROS) by NADPH oxidase. During this process, neutrophil extracellular traps (NETs) are created. NETs are extracellular structures composed of chromatin and variety of proteins from cells granules that bind and kill microorganisms. Recently, novel functions of NET have been proposed. It seems that neutrophil traps play an essential role during autoimmunity. They can induce and exacerbate diseases based on immune system malfunction.

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Infectious complications in patients with acute myeloid leukemia treated according to the protocol with daunorubicin and cytarabine with or without addition of cladribine. A multicenter study by the Polish Adult Leukemia Group (PALG)

Abstract: The addition of cladribine to standard induction chemotherapy has no impact on the incidence and spectrum of infectious complications in newly diagnosed AML patients.

Cited by 34 publications

References 35 publications

Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group

Analysis of bacteremia/fungemia and pneumonia accompanying acute myelogenous leukemia from 1987 to 2001 in the Japan Adult Leukemia Study Group

Revisiting the role of cladribine in acute myeloid leukemia: An improvement on past accomplishments or more old news?

Neutrophil Extracellular Trap in Human Diseases

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