• 제목/요약/키워드: 급성 백혈병

검색결과 143건 처리시간 0.035초

소아 급성골수성백혈병에서 관해유도 요법 중 Posaconazole의 예방적 항진균 치료 (Posaconazole for Prophylaxis of Fungal Infection in Pediatric Patients with Acute Myeloid Leukemia undergoing Induction Chemotherapy)

  • 김승민;이윤선;김재송;김수현;손은선;유철주
    • 한국임상약학회지
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    • 제28권3호
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    • pp.181-187
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    • 2018
  • Background: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML. Methods: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days. Results: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was $26.8{\pm}16days$. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49). Conclusion: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.

급성림프모구성 백혈병의 조기진단 시 구강병변 양상을 통한 감별의 중요성 (Differential Diagnosis of Oral Lesions for the Initial Diagnosis of Acute Lymphoblastic Leukemia)

  • 서미현;하지영;허경회;조영아;김성민;최진영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제35권2호
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    • pp.107-111
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    • 2013
  • Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment. Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth. A 12-year-old man visited for molar pain during 3 months. He was diagnosed with having a possibility of hematopoietic malignancy, showing the loss of lamina dura, destruction of bony crypt, and high attenuation in the bone marrow. He was referred to department of pediatrics, additional study, including peripheral cell morphology and bone marrow exam, were performed, and diagnosed as acute lymphoblastic anemia. Despite chemotherapy to cure leukemia, he was expired 8 months after initial diagnosis. The purpose of this report is to promote and evoke the awareness regarding an initial examination of the dentist to make an effort to acquire accurate knowledge and information about life-threatening disease in usual dental practice.

소아 급성 림프모구 백혈병: 과거, 현재, 미래 (Acute lymphoblastic leukemia in children: past, present and future)

  • 강형진;신희영;안효섭
    • Clinical and Experimental Pediatrics
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    • 제50권7호
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    • pp.601-605
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    • 2007
  • The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.

당귀로부터 정제한 Decursin의 인간 급성 단핵구성 백혈병 세포(THP-1 cells)의 세포 독성 및 Apoptosis에 미치는 영향 (Decursin from Angelica gigas Nakai Promotes Cytotoxicity and Induces Apoptosis in THP-1 cells, a Human Acute Monocytic Leukemia)

  • 김남석;정승일;김종석;오미진;오찬호
    • 생약학회지
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    • 제47권3호
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    • pp.197-203
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    • 2016
  • Decursin is a major component of the root of Angelica gigas(Umbelliferae), which has been traditionally used in Korea as a tonic and to treat anemia, hemiplegia, and women's diseases. The objective of this study is to identify the anti-cancer mechanism induced by decursin on apoptosis of human leukemia and lymphoma cells. Cytotoxicity of decursin on U937, HL-60, MOLT-4, THP-1 cells showed the significant effects. First of all, $IC_{50}$ of decursin on four cell lines was 27.1, 32.4, 17.4, $15.1{\mu}M$, respectively. So $IC_{50}$ in THP-1 cells was the smallest among 4 cell lines treated with decursin($15.1{\mu}M$). In order to understand the apoptosis-mechanism by decursin, we examined the gene expression of bcl-2(anti-apoptotic), bax(pro-apoptotic) and p53(tumor suppressor)after treating the THP-1 cells with decursin(10, 50 and $100{\mu}M$). It was found bcl-2 gene was decreased dose dependently, the expression level of bax gene of THP-1 cells treated with $100{\mu}M$ of decursin was about 3 times higher than those of control, and p53 gene was increased In the same concentration($100{\mu}M$), p53 gene was increased dose dependent manner. In protein express, bcl-2 and p53 protein showed a tendency to decrease. bax was increased about 4 fold. Therefore decursin is a useful chemotherapeutic agent against leukemia.

방사선치료 후 영구치 치배 발육장애 증례보고 (DEVELOPMENTAL DISTURBANCE OF PERMANENT TOOTH GERMS AFTER RADIOTHERAPY : REPORT OF CASE)

  • 강명봉;김영재;김정욱;장기택;이상훈;한세현;김종철
    • 대한소아치과학회지
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    • 제32권2호
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    • pp.251-255
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    • 2005
  • 두경부 악성 종양에 대한 방사선치료는 유용한 방법이다. 하지만 방사선치료의 부작용으로 다양한 구강내 합병증을 동반한다. 이 글에서 치열 발육 단계에 방사선치료를 받은 두 증례를 보고하는 바이다. 첫 번째 증례는 생후 19개월에 급성 골수성 백혈병으로 진단 받아 방사선치료를 받은 7세 여자 환아로 영구치 치배의 선천적 결손과 왜소치 소견을 보였다. 두 번째 증례에서는 생후 13개월에 양측성 망막아세포종으로 진단 받아 방사선치료를 받았고 영구치 치배의 선천적 결손, 왜소치, 치근의 저형성 그리고 법랑질 저형성증 소견을 보였다.

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급성 골수성 백혈병 환자에서 G-CSF를 포함한 고용량 화학요법 후 자가 말초혈 조혈모세포이식의 효과 (Autologous Peripheral Blood Stem Cell Transplantation Using G-CSF Combined Conditioning in AML Patients)

  • 김병수;국훈;황태주;최철원;김준석
    • IMMUNE NETWORK
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    • 제2권1호
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    • pp.49-52
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    • 2002
  • Background: The possibility that G-CSF recruits leukemic cells from the G0 to S phase, which may lead to a greater susceptibility to cytotoxic drugs, such as ara-C, has been presented in Harada's study. Methods: In this study, we referred to the protocol of Harada et al 1 to try G-CSF combined marrow-ablative chemotherapy and autologous PBSCT, for the treatment of AML patients in CR1 status. Between January 1997 and March 1998, six AML patients (3: children, 3: adults) in CR1 status were autografted and followed up to 3 years. Results: The major regimen related toxicity was composed of mucositis and diarrhea without death. The time of ANC recovery to 500/L and 1,000/L was 11~48 and 16~81 days, respectively. The mean time of platelet recovery to 20,000/L and 50,000/L was 21~233 and 35~370 days, respectively. The platelet recovery time to 50,000/L was markedly prolonged for more than 100 days in four patients (66.7%). Moreover, four patients (66.7%) experienced a relapse of leukemia after transplantation, with a mean interval of 147.5 days after PBSCT. Two patients were in CR status for 53 and 51 months after PBSCT, respectively. Conclusion: The G-CSF combined marrow-ablative chemotherapy and autologous PBSCT resulted in a markedly delayed platelet recovery and no advantages for decreasing the relapse rate of AML. But, further studies will be warranted.

동종 골수이식을 받은 급성 골수성 백혈병 환자의 영양상태와 생착일수에 관한 연구 (The Relationship between the Period of Engraftment and the Nutritional Status in Patients Undergoing Allogenic Bone Marrow Transplantation for Acute Myelogenous Leukemia)

  • 홍정임;장은재
    • 대한지역사회영양학회지
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    • 제7권4호
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    • pp.578-584
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    • 2002
  • This study was designed to investigate the association between the period of engraftment and the nutritional status of patient s undergoing bone marrow transplantation for acute myelogenous leukemia (AML). Nutritional status was evaluated by body mass index (BMI), percentage of ideal body weight (PIBW), percentage of weight loss, and serum albumin, total protein (T protein), hemoglobin (HGB) and hematocrit (HCT) levels on the day prior to transplantation and on the day of bone marrow transplantation. The periods of engraftment were determined by absolute neutrophil counts (ANC) above $500/mm^3$ from the day of bone marrow transplantation. The study subjects were 80 patients (55 males, 25 females) with acute myelogenous leukemia admitted to the University Hospital in Seoul. The result of this study is as follows : Tie nutritional status values of the majority of patients on the day prior to transplantation were in the normal range except for HGB and HCT ; however, during hospitalization, all of the levels of the nutritional status values were significantly decreased. The periods of engraftment of the abnormal group according to their BMI, PIBW, HGB and HCT levels on the day of bone marrow transplantation showed no difference when compared to the normal group. However, the periods of engraftment of the abnormal group, according to the percentage of weight loss, albumin, and T protein levels were significantly decreased when compared to the normal group. Therefore, the nutritional status of patients at the time of transplant had a noticeable influence on the periods of engraftment. Our results suggested that nutritional status is a critical factor of engraftment in BMT during pre-transplant and post-transplant. Futhermore, we recommend that the process of nutritional preparation for the transplant should initiate immediately after the transplant decision has been made.

항암 화학요법중인 급성 골수성 백혈병 환자의 구강내 세균변화에 관한 연구 (Changes in the Oral Microflora in Patients with Acute Myeloid Leukemia during the Period of Induction Therapy)

  • Byul-Hee Lee;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • 제18권1호
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    • pp.73-82
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    • 1993
  • To investigate the changes in aerobic and facultative anaerobic oral microflora during remission-induction chemotherapy in patients with acute myeloid leukemia, 10 consecutive patients were studied during a period of 28 days. One day before, during and after the induction therapy, patients were given 10% Betadine solution for mouthrinses after breakfast and kept from eating and drinking. After 3 hours, paraffin-stimulated whole saliva was obtained for 2 minutes and transported to the laboratory. The samples were dispersed and homogenized by use of vortex mixer for 20 seconds. From these samples 10-fold serial dilutions (from 10-1 through 10-3) were prepared. Each dilution of 0.1 ml was plated on duplicate set of one nonselective medium (Blood agar) and four selective media (Sabourauds dextrose agar, Mannitol salt agar, Mac-Conkey agar, SF medium ) using applicator woods. All agar plate were incubated at 37$^{\circ}C$ for 48 hours. The total number of microorganisms was calculated and the percentage distribution of the various microorganisms from each specimen was drawn. 1. The salivary flow rate decreased by 66%, going from 5.38 ml/2min to 1.81 ml/2min over two days during the chemotherapy. 2. The total number of microorganisms in saliva increased by 22%, going from 4.88$\times$105/ml to 6.00$\times$105/ml over two days during the chemotherapy. 3. The salivary flow rate and the total number of microorganisms in saliva were recovered within 28 days after the chemotherapy. 4. The quantitative alteration in oral Enterobacteria, Enterococci, Staphylococci, Cndida during the chemotherapy had no statistical significance. 5. In saliva of the patients with acute myeloid leukemia who ahd intraoral ulcer, Enterobacteria was quantitatively predominent. Our study suggests that chemotherapy-induced transient xerostomia may induce acute oral infection. Consequently, the use of saliva substitute, the removal of intraoral infection source and the consistent oral hygiene care seem to be required to avoid the transmission of potential pathogenes in this group of patients.

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다발성 연조직 종괴를 동반한 급성 림프구성 백혈병의 증례 보고 (Case report of acute lymphoblastic leukemia with multiple soft tissue mass)

  • 장정용;허경회;이원진;허민석;이삼선;최순철
    • Imaging Science in Dentistry
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    • 제35권2호
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    • pp.111-114
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    • 2005
  • A 15-year-old patient, who had been diagnosed and treated as Burkitt cell type acute lymphoblastic leukemia (ALL-L3) already, visited our department. He complained of gingival enlargement and loosening teeth 1 month ago. The clinical examination revealed anterior open bite, gingival enlargement, and nontender swelling particularly in molar regions of both jaws. Deep periodontal pockets and severe mobility was shown on most of the teeth. The panoramic radiographs showed severe bone destruction and extrusion of the molars. The contrast enhanced CT showed multiple enhanced mass and bone marrow obliteration in both jaws. Chemotherapy was done and the swelling was subsided at 1 month later. In conclusion, radiologic findings of leukemia with soft tissue mass, known as chloroma or granulocytic sarcoma, mimic those of lymphoma, so blood test may be needed for the final diagnosis.

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혈액종양 질환 환자에서 발생한 침습성 폐 국균증의 수술적 치료 - 2예 보고 - (Surgical Management of Invasive Pulmonary Aspergillosis in Hemtologic Malignancy Patients - Report of 2 cases -)

  • 범민선;송상윤;김병표;박정민;이교선;나국주
    • Journal of Chest Surgery
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    • 제40권1호
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    • pp.69-73
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    • 2007
  • 혈액종양 질환 환자에서 항암요법에 의한 골수기능 저하상태에서 발생할 수 있는 침습성 폐 국균증은 항진균제의 사용에도 불구하고 사망률이 높다. 적절한 항진균제의 사용과 함께 수술적 절제가 침습성 폐 국균증의 사망률을 낮출 수 있다고 보고되고 있다. 최근 저자들은 급성 림프구성 백혈병으로 진단된 환아 2명에서 침습성 폐 국균증을 효과적인 항진균제와 함께 수술적 절제를 통해 치료하여 좋은 결과를 치험하였다. 이에 문헌고찰과 함께 보고하는 바이다.