Treatment of an Elderly Patient with Acute Myeloid Leukemia and Invasive Pulmonary Aspergillosis Infection with Combined Allogeneic Hematopoietic Stem Cells Microtransplantation and Voriconazole

Nie, Weiye; Huang, Qin; Chen, Yongsheng; Yin, Xiaolin

doi:10.1007/s12288-015-0601-7

Cited by 3 publications

(3 citation statements)

References 5 publications

(6 reference statements)

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“…When the pathogen invades the lower respiratory tract of AL patients, it will cause structural and functional damage to lung and tracheal tissues, lead to the changes in respiratory rhythm and frequency, dyspnea and other serious respiratory symptoms. CAP frequently occurs, which is closely related to the immune, defense and hematopoietic dysfunction, application of chemotherapy drugs, hormones and broad-spectrum antibiotics and long LOS due to induction therapy ( 12 – 14 ). The results of this study showed that the total distribution ratio of pathogens from high to low in the two groups was as follows: bacterium, virus, fungus, mycoplasma and chlamydia trachomatis; there was no significant difference between the groups (P>0.05), indicating that the infection pathogens of either SCAP or non-SCAP patients are mostly bacteria and viruses.…”

Section: Discussionmentioning

confidence: 99%

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

Duan

Zhang

2018

Oncol Lett

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The risk factors and coping strategies of severe community-acquired pneumonia (SCAP) in chemotherapy induction period of acute leukemia were investigated. Eighty-six patients with CAP in chemotherapy induction period of acute leukemia in Dezhou Hospital from March 2014 to February 2017 were selected and divided into observation group (SCAP group, n=45) and control group (non-SCAP group, n=41) according to the acute physiology and chronic health evolution II (APACHE II) score. The blood, sputum, nasopharyngeal secretion and pleural effusion samples were collected from patients in both groups, and the samples were detected for pathogens, followed by the analysis of relevant factors. The dynamic changes in the sequential organ failure assessment (SOFA) score, procalcitonin (PCT), D-dimer (D-D) and C-reactive protein (CRP) levels in patients were observed before and after the corresponding treatment strategies were taken. The total distribution ratio of pathogens from high to low in the two groups was as follows: bacterium, virus, fungus, mycoplasma and chlamydia trachomatis; there was no significant difference between the two groups (P>0.05). Logistic regression analysis showed that the repeated infection (OR=3.315, P=0.005), multi-resistant bacterial infection (OR=1.915, P=0.008) and D-D (OR=1.936, P=0.009) were independent risk factors for SCAP (P<0.05). After different coping strategies were taken, the SOFA score, PCT, D-D and CRP levels in the two groups were significantly decreased, and they were obviously higher in observation group than those in control group (P<0.05). Repeated infection, D-D level and multi-resistant bacterial infection are the risk factors affecting the SCAP in chemotherapy induction period of acute leukemia. The coping strategies can effectively relieve the patient's condition, reduce the severity of disease and improve the survival rate of patients.

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Section: Discussionmentioning

confidence: 99%

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

Duan

Zhang

2018

Oncol Lett

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“…Our center has repeatedly made use of such cells combined with antibiotics to rescue patients with highly refractory, pan resistant bacterial infections, achieving results better than expected. (23). Although nearly 36% of the patients in this study experienced various infection-related complications during treatment, most of the patients were effectively cured, and mortality was predictably attributable to various complications following leukemia relapse.…”

Section: Discussionmentioning

confidence: 73%

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Guo

et al. 2021

Preprint

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BackgroundThe treatment outcomes of elderly patients aged over 70 with acute myeloid leukemia (AML) have been very disappointing. In comparison, our designed HLA-mismatched hematopoietic stem cell micro-transplantation (MST) has achieved such encouraging treatment results in AML patients as might warrant further investigations of the outcomes of MST for the above mentioned patients. MethodsOne hundred and eleven patients aged 70-88 years were enrolled. Eighty patients were assigned to the high-risk MST or standard MST group according to high-risk prognostic factors. The other thirty-one patients were assigned to either the chemotherapy group or support group. After receiving induction chemotherapy with cytarabine and anthracycline, patients who achieved complete remission (CR) were given another 2 cycles of post-remission therapy with cytarabine. Each chemotherapy regimen was followed by donor stem cell infusion in the MST groups. ResultMST achieved an encouragingly high CR rate in patients (63.8%), even in high-risk patients (54%). It was significantly higher than that in the chemotherapy alone group. The 1-year overall survival (OS) of MST patients was 57.7% and was 68.6% in the high-risk and standard group, respectively, whereas the OS was only 37.3% in the chemotherapy group. The severe infection rate was 36% and 54% in MST and chemotherapy group. No GVHD was observed in MST patients. A larger updated T cell clones was observed in MST patients by T cell receptor repertoire analysis with a Next Generation Sequencing methodology. ConclusionsThese results suggested that MST is a safe and practical treatment regimen conducive to a longer-term survival for AML patients at a highly advanced age.

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“…There are 13 published reports of studies using a microtransplantation approach for persons with AML only (Table). A randomized clinical trial of elderly individuals (>65 years of age) with AML compared chemotherapy with (n = 28) or without (n = 30) microtransplantation . Participants receiving a microtransplant had a higher rate of histologic complete remission (80% [95% CI, 65%-95%] vs 43% [95% CI, 23%-63%]; P = .006), 2-year leukemia-free survival (39% [95% CI, 20%-58%] vs 10% [95% CI, 0%-20%]; P = .01) and 2-year survival (39% [95% CI, 21%-57%] vs 10% [95% CI, 0%-22%]; P = .006).…”

Section: Resultsmentioning

confidence: 99%

Microtransplantation for Acute Myeloid Leukemia

2020

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Treatment of an Elderly Patient with Acute Myeloid Leukemia and Invasive Pulmonary Aspergillosis Infection with Combined Allogeneic Hematopoietic Stem Cells Microtransplantation and Voriconazole

Cited by 3 publications

References 5 publications

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

Risk factors and coping strategies of severe community-acquired pneumonia in chemotherapy induction period of acute leukemia

Stem Cells Micro-transplantation in Elderly Patients Aged Over 70 With Acute Myeloid Leukemia: a Multicenter, Prospective, Non-interventional Study

Microtransplantation for Acute Myeloid Leukemia

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