Prevention of Infections in Patients with Hematological Malignancies

Nucci, Márcio; Anaissie, Elias; Dignani, María Cecilia; Mahfouz, Tahsine

doi:10.1007/978-1-4614-3764-2_51

Cited by 6 publications

(4 citation statements)

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“…The presence of invasive fungal infections in patients with hematological malignancies is already well documented as the evidence of fungal infections at autopsy has already been found in 20-50% of the patients with such malignancies [44,45]. This is possibly due to the enhanced risk of infection in patients with hematological malignancies leading to morbidity and mortality [46]. In our study, the non-survivors appeared to have a longer stay at hospital and required ICU admission, which is also evident in a recent study [12].…”

Section: Plos Onementioning

confidence: 97%

Clinical manifestations, associated risk factors and treatment outcomes of Chronic Pulmonary Aspergillosis (CPA): Experiences from a tertiary care hospital in Lahore, Pakistan

et al. 2021

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Background Chronic pulmonary aspergillosis (CPA) has a wide spectrum of illnesses depending on the progression of the disease and comorbid conditions. However, there is an inadequacy of investigations regarding clinical, laboratory, risk factor and prognostic data on CPA. The current study is aimed to consider the clinical manifestations, risk factors and outcomes of CPA. Methodology Retrospective records of all patients with a confirmed diagnosis of CPA who sought treatment at Gulab Devi Chest Hospital Lahore, Pakistan from January 2017 to December 2019 were evaluated. Data regarding demographics, clinical manifestations, comorbidities, radiographic and microbiological findings, length of hospital stay (LOS) and intensive care unit (ICU) admission was collected and analyzed to identify the factors associated with mortality. The independent factors associated with mortality were also identified by appropriate analyses. Results A total of 218 CPA patients were included in this study. The mean age was 45.75 ± 6.26 years. Of these, 160 (73.4%) were male, and 65 (29.8%) had diabetes. The mean LOS was 18.5 ± 10.9 days. The most common type of CPA was simple aspergilloma (56%) followed by chronic cavitary pulmonary aspergillosis (CCPA) (31.2%). About one half of the patients had a history of pulmonary tuberculosis (TB) and treatment response rates were low in patients with active TB. The overall mortality rate was 27.1%. ICU admission was required for 78 (35.8%) patients. Diabetes mellitus (DM), hematological malignancies and chronic kidney disease (CKD) were the common underlying conditions predicting a poor outcome. Mean LOS, hematological malignancies, consolidation and ICU admission were identified as the independent factors leading to mortality. Conclusions CPA had a significant association with TB in the majority of cases. Treatment response rates in cases with active TB were comparatively low. Cases with high mean LOS, hematological malignancies, consolidation, ICU admission, CKD and DM experienced poor outcomes. High mean LOS, hematological malignancies, consolidation and ICU stay were identified as independent risk factors for mortality. Future large prospective studies, involving aspergillus specific immunoglobulin G (IgG) antibody testing, are required for a better understanding of CPA in Pakistan.

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Section: Plos Onementioning

confidence: 97%

Clinical manifestations, associated risk factors and treatment outcomes of Chronic Pulmonary Aspergillosis (CPA): Experiences from a tertiary care hospital in Lahore, Pakistan

et al. 2021

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“…During the period of aplasia (2-3 weeks), patients have to be carefully monitored and receive supportive medication, including blood products and antibiotics. The severe neutropenia contributes to the enhanced susceptibility to infections and high mortality at this stage [6][7][8][9] . Twentyeight % of AML patients survive for 5 years (www.seer.cance r.gov).…”

mentioning

confidence: 99%

Associations of ficolins and mannose-binding lectin with acute myeloid leukaemia in adults

Sokołowska

Świerzko

Gajek

et al. 2020

Sci Rep

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We investigated clinical associations of ficolins and mannose-binding lectin (MBL) in 157 patients suffering from acute myeloid leukaemia (AML). Concentrations of ficolin-1, ficolin-2, ficolin-3 and MBL (before chemotherapy) in serum were determined as were selected polymorphisms of the corresponding genes (FCN1, FCN2, FCN3 and MBL2). The control group (C) consisted of 267 healthy unrelated individuals. Median level of ficolin-1 in patients was lower (p < 0.000001) while median levels of ficolin-2, ficolin-3 and MBL were higher (p < 0.000001, p < 0.000001 and p = 0.0016, respectively) compared with controls. These findings were generally associated with AML itself, however the highest MBL levels predicted higher risk of severe hospital infections (accompanied with bacteremia and/or fungaemia) (p = 0.012) while the lowest ficolin-1 concentrations tended to be associated with prolonged (> 7 days) fever (p = 0.026). Genotyping indicated an association of G/G homozygosity (corresponding to FCN1 gene − 542 G > A polymorphism) with malignancy [p = 0.004, OR = 2.95, 95% CI (1.41-6.16)]. Based on ROC analysis, ficolin-1,-2 and-3 may be considered candidate supplementary biomarkers of AML. Their high potential to differentiate between patients from non-malignant controls but also from persons suffering from other haematological cancers (multiple myeloma and lymphoma) was demonstrated. Abbreviations AML Acute myeloid leukaemia ANC Absolute neutrophil count FN Febrile neutropenia MBL Mannose-binding lectin PLT Platelet count WBC Leukocyte count Acute myeloid leukaemia (AML) is the most common leukaemia affecting adults (approximately 80%; > 1% of total cancers). It is an aggressive malignancy, characterized by clonal proliferation and accumulation of morphologically and functionally immature blast cells, originating from progenitor haematopoietic cells after neoplastic

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“…Infection is a major complication in patients with hematologic malignancies. 1 The increased risk of infection is a consequence of severe immunosuppression caused by the disease itself and its treatment. The effects of cancer chemotherapy on the immune system include bone marrow suppression resulting in neutropenia, mucosal barrier disruption and suppressive effects on T-cells and B-cells.…”

Section: Introductionmentioning

confidence: 99%

“…The effects of cancer chemotherapy on the immune system include bone marrow suppression resulting in neutropenia, mucosal barrier disruption and suppressive effects on T-cells and B-cells. 1 On the other hand, the treatment of hematologic malignancies has changed substantially over the past 15 years, with the introduction of novel therapies that, unlike conventional chemotherapy, have specific targets in neoplastic cells, potentially reducing the deleterious effects of the treatment on host immune defenses. However, infections may occur, either by a predicted effect of these agents on the immune system, or by an unanticipated immunosuppression.…”

Section: Introductionmentioning

confidence: 99%