• 제목/요약/키워드: Neutropenia

검색결과 202건 처리시간 0.034초

Meropenem Versus Piperacillin-Tazobactam as Empiric Therapy for Febrile Neutropenia in Pediatric Oncology Patients

  • Sezgin, Gulay;Acipayam, Can;Ozkan, Ayse;Bayram, Ibrahim;Tanyeli, Atila
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권11호
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    • pp.4549-4553
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    • 2014
  • Background: Infection is a serious cause of mortality in febrile neutropenia of pediatric cancer patients. Recently, monotherapy has replaced the combination therapy in empirical treatment of febrile neutropenia. Since there has been no reported trial comparing the efficacy of meropenem and piperacillin-tazobactam (PIP/TAZ) monotherapies, the present retrospective study was conducted to compare safety and efficacy in febrile neutropenic children with cancer. Materials and Methods: Charts of febrile, neutropenic children hospitalized at our center between March 2008 and April 2011 for hemato-oncological malignancies were reviewed. Patients received PIP/TAZ 360 mg/kg/day or meropenem 60 mg/kg/day intravenously in three divided doses. Duration of fever and neutropenia, absolute neutrophil count, modification, and success rate were compared between the two groups. Resolution of fever without antibiotic change was defined as success and resolution of fever with antibiotic change or death of a patient was defined as failure. Modification was defined as changing the empirical antimicrobial agent during a febrile episode. Results: Two hundred eighty four febrile neutropenic episodes were documented in 136 patients with a median age of 5 years. In 198 episodes meropenem and in 86 episodes PIP/TAZ were used. Duration of fever and neutropenia, neutrophil count, sex, and primary disease were not different between two groups. Success rates and modification rate between two groups showed no significant differences (p>0.05). Overall success rate in the meropenem and PIP/TAZ groups were 92.4% and 91.9% respectively. No serious adverse effects occurred in either of the groups. Conclusions: Meropenem and PIP/TAZ monotherapy are equally safe and effective in the initial treatment of febrile neutropenia in children with cancer.

Leucogen Tablets at 60 mg Three Times per Day are Safe and Effective to Control Febrile Neutropenia

  • Huang, Xin-En;Cao, Jie;Qian, Zhi-Ying;Xu, Xia;Shi, Lin;Wu, Xue-Yan;Liu, Jin;Wang, Lin
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권19호
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    • pp.8495-8497
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    • 2014
  • Purpose: To investigate whether it is safe to use leucogen tablets 60 mg three times per day (180 mg for a day) and whether this regimen could reduce the incidence of febrile neutropenia caused by chemotherapy. Methods: This prospectively designed study focused on the safety and effectiveness of leucogen tablets 60mg three times per day for a group of cancer patients during chemotherapy for mainly lung or gastric cancers. The tablets were administered from 5 days before until the termination of chemotherapy. Neutropenia and other healthcare encounters were defined as events and occurrence was estimated for comparison. Results: We identified 39 patients receiving leucogen tablets 60mg three times per day, including 11 with gastric, 12 with lung and 16 with other sites of cancer. The mean age was 65 (29-75) years and there were 27 male and 12 female patients. The mean duration of leucogen tablets intake was 59 days. Eighteen patients were treated with taxane-based, 4 with irinotecan-based and 17 with other chemotherapy. The incidence of febrile neutropenia was 0%. Twelve patients were found severe neutropenia (grade III/IV), and the duration of severe neutropenia (grade III/IV) was 5 days. Treatment-emergent adverse events were attributable to complications of myelosuppressive chemotherapy or the primary disease (i.e., alopecia, nausea, asthenia, neutropenia, and severe hepatic renal dysfunction). No chemotherapy was delayed and no treatment related death was observed. Conclusions: This study suggested that leucogen tablets 60mg three times per day (180mg for a day) are safe and could be effective for preventing febrile neutropenia in patients with chemotherapy.

RUNX1 Mutations in the Leukemic Progression of Severe Congenital Neutropenia

  • Olofsen, Patricia A.;Touw, Ivo P.
    • Molecules and Cells
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    • 제43권2호
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    • pp.139-144
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    • 2020
  • Somatic RUNX1 mutations are found in approximately 10% of patients with de novo acute myeloid leukemia (AML), but are more common in secondary forms of myelodysplastic syndrome (MDS) or AML. Particularly, this applies to MDS/AML developing from certain types of leukemia-prone inherited bone marrow failure syndromes. How these RUNX1 mutations contribute to the pathobiology of secondary MDS/AML is still unknown. This mini-review focusses on the role of RUNX1 mutations as the most common secondary leukemogenic hit in MDS/AML evolving from severe congenital neutropenia (SCN).

Extensive gingival necrosis and sequestration of the alveolar bone caused by methimazole-induced neutropenia and three-year follow-up

  • Kim, Eun-Cheol;Park, Joon Bong;Hong, Ji-Youn;Kang, Kyung Lhi
    • Journal of Periodontal and Implant Science
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    • 제45권2호
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    • pp.76-80
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    • 2015
  • Purpose: Methimazole is an anti-thyroid drug that can cause life-threatening neutropenia in rare situations. The aim of this case report is to describe a set of oral complications associated with methimazole-induced neutropenia and the healing of the gingiva after proper treatment. Methods: A 31-year-old female patient hospitalized for systemic symptoms of sore throat and fever and showing extensive gingival necrosis with pain was referred to the Department of Periodontics from the Department of Endocrinology. Methimazole-induced neutropenia was diagnosed based on blood test results and her medical history. Methimazole was discontinued and a range of treatments was administered, including the injection of granulocyte colony stimulating factor. Results: After systemic treatment, the gingiva began to heal as the neutrophil count increased. Approximately one year later, the gingiva had returned to a normal appearance. Twenty-one months after treatment, sequestra of the alveolar bone that had broken through the gingiva were removed. Periodic supportive periodontal treatment has been continued uneventfully. Conclusions: The oral manifestations of gingival necrosis and ulcerations, in combination with systemic symptoms such as fever and sore throat, are the critical signs presented in the early stages of drug-induced neutropenia. Therefore, dentists need to be aware of these oral complications in order to make an accurate diagnosis and to ensure that prompt medical intervention is provided.

Which One is More Effective, Filgrastim or Lenograstim, During Febrile Neutropenia Attack in Hospitalized Patients with Solid Tumors?

  • Sonmez, Ozlem Uysal;Guclu, Ertugrul;Uyeturk, Ummugul;Esbah, Onur;Turker, Ibrahim;Bal, Oznur;Budakoglu, Burcin;Arslan, Ulku Yalcintas;Karabay, Oguz;Oksuzoglu, Berna
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권3호
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    • pp.1185-1189
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    • 2015
  • Background: Chemotherapy-induced febrile neutropenia (FN) with solid tumors causes mortality and morbidity at a significant rate. The purpose of this study was to compare the effects of filgastrim and lenograstim started with the first dose of antibiotics in hospitalized patients diagnosed with FN. Materials and Methods: Between February 2009 and May 2012, 151 patients diagnosed with FN were evaluated, retrospectively. In those considered appropriate for hospitalization, convenient antibiotic therapy with granulocyte colony stimulating factors was started within first 30 minutes by completing necessary examinations in accordance with FEN guide recommendations. Results: In this study, 175 febrile neutropenia attacks in 151 patients were examined. Seventy three of the patients were male and 78 were female. The average age was 53.6 and 53.6, respectively. The most common solid tumor was breast carcinoma in 38 (25%). One hundred and five FN patients (58%) were those who received granulocyte colony stimulating factors as primary prophylaxis. Conclusions: While studies comparing both drugs generally involve treatments started for prophylaxis, this study compared the treatment given during the febrile neutropenia attack. Compared to lenograstim, filgastrim shortens the duration of hospitalization during febrile neutropenia attack by facilitating faster recovery with solid tumors.

항암화학요법을 받은 유방암환자의 호중구 감소증 발생실태와 영향요인 (Incidence and Factors Influencing Neutropenia in Patients with Chemotherapy)

  • 주은실
    • 한국산학기술학회논문지
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    • 제19권6호
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    • pp.519-525
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    • 2018
  • 본 연구는 항암화학요법을 받은 유방암 환자의 호중구 감소증 발생실태를 확인하고 영향을 미치는 위험요인에 따른 발생 차이를 확인하고자 시행한 연구이다. 2010년 1월부터 2016년 3월까지 서울소재 일개 대학병원의 여성외과와 내분비 외과로 입원하거나 외래에서 항암화학요법을 받은 유방암환자 353명을 대상으로 전자 의무기록을 이용하여 자료를 수집하였다. 수집된 자료는 SPSS 20.0을 이용하여 기술통계와 $X^2-test$, 로지스틱회귀분석을 실시하였다. 연구 대상자 353명 중 33.1%에서 호중구 감소증이 발생하였으며, 그 가운데 5.1%만 발열증상이 있었다. 호중구 감소증 유무에 따라 유의한 차이를 나타내는지 환자 관련 위험요인. 치료 관련 위험요인, 질병 관련 위험요인별로 확인한 결과 신체활동능력, 방사선치료 여부, Regimen에 차이를 보였다. 그 가운데 신체활동능력이 호중구 감소증에 영향을 미치는 요인으로 나타났다. 본 연구의 결과는 항암화학요법을 받는 유방암환자의 호중구 감소증 발생 가능성을 예측하여 가능성이 높은 환자에게 미리 적절한 교육과 간호중재를 제공함으로써 호중구 감소증 및 감염발생을 예방하는데 필요한 기초자료를 제공하였다는데 의의가 있다.

주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고 (ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA)

  • 강은주;최남기;김선미
    • 대한소아치과학회지
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    • 제40권2호
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    • pp.133-140
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    • 2013
  • 주기성 호중구 감소증은 호중구의 수가 감소하였다가 다시 정상으로 회복되는 반응이 주기적으로 나타나는 혈액질환이다. 임상적 증상으로 발열, 실신, 두통 등이 있으며 구강 내 증상으로 동통성 연조직 궤양이 특징적인데 특히 입술, 혀, 협점막, 치은이 흔하게 이환 된다. 또한, 치조골 파괴를 동반한 급진성 치주조직 상실을 보이기도 한다. 본 증례의 환아는 4세 1개월의 남아로서 잇몸이 붓고 이가 흔들린다는 것을 주소로 본과에 내원하였다. 환아는 주기성 호중구 감소증 환자로서 하악 전치부 5개 치아를 제외한 모든 유치에 우식이 있었으며 동요를 보이는 하악 좌 우 제1유구치의 국소적 치조골 소실을 확인할 수 있었다. 환아는 주기성 호중구 감소증에 기인한 광범위한 치아우식증, 치은염, 국소적 치주염으로 진단되었고 치료를 시행하였다. 주기성 호중구 감소증 환자에게는 정기적인 구강위생관리와 함께 치아우식, 치은염에 대한 시기적절한 치료가 필요하며 특히 어린 환자들에 있어서 영구치열 형성에 장애가 발생하지 않도록 조기에 개입을 하는 것이 중요하다.

간경변 환자에서 콜히친 사용에 의한 호중구성 백혈구감소증 1예 (A Case of Colchicine-Induced Neutropenia in Liver Cirrhosis Patient)

  • 이호찬;이헌주;김용길;박재현;김성준;박준석
    • Journal of Yeungnam Medical Science
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    • 제26권2호
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    • pp.125-129
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    • 2009
  • Colchicine is an alkaloid that has been used for treating acute gouty arthritis, psoriasis, scleroderma and Behcet's syndrome. Colchicine decreased liver fibrosis in rats with carbon tetrachloride induced cirrhosis and in patients with many liver diseases. Therapeutic oral doses of colchicine may cause nausea, vomiting, abdominal pain and diarrhea. The adverse effect of colchicine associated with the dose is bone marrow suppression, and especially neutopenia. Neutropenia has often been reported in patients have taken an overdose of colchicine. We describe a 64-year-old female liver cirrhosis patient with neutropenia that was induced by a therapeutic dose of colchicine.

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호중구 감소를 동반한 길랑바레 증후군에 대한 한의 복합 치료 증례보고 1례 (A Case Report of Guillain-Barré Syndrome with Neutropenia Improved by Combined Korean Medicine Treatment)

  • 정은선;유호룡;김윤식;설인찬
    • 대한중풍순환신경학회지
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    • 제21권1호
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    • pp.57-66
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    • 2020
  • 본 증례보고는 GBS를 진단받고 IVIg치료 후 호중구 감소증이 동반된 환자를 위증(痿證)으로 변증하여 한약, 침구치료, 물리치료를 통해 환자의 증상 호전을 보였기에 보고하는 바이다.

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