Intestinal toxicity during induction chemotherapy with cytarabine-based regimens in adult acute myeloid leukemia

Camera, Andrea; Andretta, Claudia; Villa, Maria Rosaria; Volpicelli, Mario; Picardi, Marco; Rossi, Marco; Rinaldi, Ciro R.; Cioppa, Paola Della; Selleri, Carmine; Rotoli, Bruno

doi:10.1038/sj.thj.6200304

Cited by 27 publications

(23 citation statements)

References 12 publications

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“…All of our patients received chemotherapy over the 3 weeks preceding demonstration of fungal infection, in particular they all received cytarabine. Cytarabine is known to alter the integrity of the intestinal mucosal barrier; even in the French experience, the majority of patients were exposed to this agent . Only one of our patients complained of diarrhoea and research of G. clavatum on rectal swabs resulted negative in all.…”

Section: Discussionmentioning

confidence: 56%

A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature

Principe

Sarmati

Cefalo

et al. 2016

Mycoses

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Invasive fungal infections, usually Aspergillus and Candida, represent a major cause of morbidity and mortality in patients with malignant haematological diseases, but in the last years rare fungal infections have more frequently been reported. Here, we report the clinical history of three patients affected with haematological malignancies who developed an infection caused by Geotrichum (G.) clavatum. Two out of three patients were affected by acute myeloid leukaemia (AML), and one by mantle cell lymphoma (MCL). All patients received cytarabine-based chemotherapeutic regimens and developed G. clavatum infection within 3 weeks from therapy initiation. In all cases, G. clavatum was isolated from central venous catheter and peripheral blood cultures. In vitro susceptibility test confirmed an intrinsic resistance to echinocandins and, in all cases, visceral localisations (spleen, liver and lung) were documented by total body computed tomography (CT) scan. A prolonged antifungal therapy with high doses liposomal amphotericin-B was necessary to obtain fever resolution. Only the patient with MCL died while the other two AML recovered, and one of them after received an allogeneic stem cell transplantation. We consecutively reviewed all published cases of infection caused by G. clavatum. Our experience and literature review indicate that G. clavatum can cause invasive infection in haematological patients, mainly in those with acute leukaemia.

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Section: Discussionmentioning

confidence: 56%

A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature

Principe

Sarmati

Cefalo

et al. 2016

Mycoses

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“…Prior studies have evaluated the rates of febrile neutropenia, bleeding and invasive fungal infections in AML patients, but these were primarily in the clinical trial setting or were single centre studies and did not present differences by age. (Camera et al , 2003; Lowenberg et al , 2011; De Rosa et al , 2013; Ferrara & Schiffer, 2013; Garcia et al , 2013; Buckley et al , 2014) To our knowledge, no population-based studies have considered the effect of complications on early mortality in AML patients. (Juliusson et al , 2012) Because early mortality continues to be a barrier to improving long-term survival and age is a major prognostic factor, (Juliusson et al , 2009) evaluating the factors that impact early mortality on a population-based level will identify targeted areas for improvement.…”

Section: Introductionmentioning

confidence: 99%

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Jonas

et al. 2017

Br J Haematol

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SUMMARY Few studies have evaluated the impact of complications, sociodemographic and clinical factors on early mortality (death ≤ 60 days from diagnosis) in acute myeloid leukaemia (AML) patients. Using data from the California Cancer Registry linked to hospital discharge records from 1999–2012, we identified patients aged ≥ 15 years with AML who received inpatient treatment (N=6359). Multivariate logistic regression analyses were used to assess the association of complications with early mortality, adjusting for sociodemographic factors, comorbidities and hospital type. Early mortality decreased over time (25.3%, 1999–2000; 16.8%, 2011–2012) across all age groups, but was higher in older patients (6.9%, 15–39, 11.4%, 40–54, 18.6% 55–65, and 35.8%, > 65 years). Major bleeding (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.3–1.9), liver failure (OR 1.9, 95% CI 1.1–3.1), renal failure (OR 2.4, 95% CI 2.0–2.9), respiratory failure (OR 7.6, 95% CI 6.2–9.3) and cardiac arrest (OR 15.8, 95% CI 8.7–28.6) were associated with early mortality. Higher early mortality was also associated with single marital status, low neighbourhood socioeconomic status, lack of health insurance and comorbidities. Treatment at National Cancer Institute-designated cancer centres was associated with lower early mortality (OR 0.5, 95% CI 0.4–0.6). In conclusion, organ dysfunction, hospital type and sociodemographic factors impact early mortality. Further studies should investigate how differences in healthcare delivery affect early mortality.

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“…Literature indicates that complications in patients being treated for leukemia are increasing [1][2][3][4][5][6][7][8]. This is believed to be secondary to advances in early diagnosis, advanced chemotherapeutic agents coupled with better supportive care leading to higher remission rates, and increased survival.…”

Section: Discussionmentioning

confidence: 97%

Extramedullary Involvement of the Sigmoid Colon with Acute Lymphocytic Leukemia

Issak

Agrawal

2016

J Gastrointest Canc

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Intestinal toxicity during induction chemotherapy with cytarabine-based regimens in adult acute myeloid leukemia

Abstract: This retrospective analysis shows that NE is a serious complication occurring mainly in patients treated by Ara-C administered as continuous i.v. infusion.

Cited by 27 publications

References 12 publications

A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature

A cluster of Geotrichum clavatum (Saprochaete clavata) infection in haematological patients: a first Italian report and review of literature

Early mortality and complications in hospitalized adult Californians with acute myeloid leukaemia

Extramedullary Involvement of the Sigmoid Colon with Acute Lymphocytic Leukemia

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