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  • 1
    Electronic Resource
    Electronic Resource
    High risk of streptococcal septicemia after high dose cytosine arabinoside treatment for acute myelogenous leukemia (1987)
    Springer
    Journal of molecular medicine 65 (1987), S. 773-780 
    Details
    ISSN: 1432-1440
    Keywords: Streptococci ; Septicemia ; Acute leukemia ; High dose cytosine arabinoside
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Twenty-nine adult patients with acute myelogenous leukemia AML who received 40 treatment courses with high dose cytosine arabinoside (HD-A), alone or combined with other cytotoxic drugs, for remission induction (RI) or postremission intensive consolidation (IC) were retrospectively analysed for types and severity of infectious complications. In this paper, we report the unusually high rate of streptococcal septicemia in our patients. Of 13 bacteremic infections in a total of 45 infectious episodes, 10 were caused by streptococci (9 viridans streptococci, 1 group B hemolytic streptococcus). Three of them were lethal. After reviewing all documented cases of streptococcal septicemia in the same study period, four additional cases among adult patients with AML were identified. Three of them have had antileukemic chemotherapy without HD-A, while one have had HD-A as a conditioning regimen for bone marrow transplantation. Only three cases were documented to occur in adult patients with AML. Patients treated with HD-A for RI or IC had a significantly lower risk of streptococcal septicemia during previous chemotherapy-associated febrile neutropenic episodes (1/55 vs 10/45;P=0.01). Neither prophylactic regimens including trimethoprim-sulfamethoxazole nor those without it were effective in preventing streptococcal septicemia. Further studies are needed to confirm these data before the value of additional or alternative prophylactic antibiotics is proven necessary.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01743253
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  • 2
    Electronic Resource
    Electronic Resource
    The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia (1980)
    Springer
    Annals of hematology 40 (1980), S. 187-195 
    Details
    ISSN: 1432-0584
    Keywords: akute LeukÄmie ; Infektionsprophylaxe ; antimikrobielle ; Dekontamination ; reverse Isolation ; Remissionsraten ; Acute leukemia ; Prevention of infection ; Antimicrobial decontamination ; Reverse isolation ; Remission rates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The efficiency of strict reverse isolation and antimicrobial decontamination in remission induction therapy of acute leukemia was studied retrospectively in 47 patients who were treated with a standardized aggressive chemotherapy of daunorubicin and cytosine arabinoside. Twenty-two patients were treated in strict reverse isolation with antimicrobial decontamination and 25 patients in the open ward without any measures against infections. In the patients in isolation the incidence of new infections per patient was 0.77 compared to 1.42 in the control group. The rate of complete remissions was 77% in the patients in isolation vs. 56 % in the control patients.
    Notes: Zusammenfassung Die Wirksamkeit von strikter reverser Isolation und antimikrobieller Dekontamination bei der Induktionstherapie der akuten LeukÄmie wurde retrospektiv bei 47 Patienten untersucht. Alle Patienten erhielten eine standardisierte aggressive Chemotherapie mit Daunorubicin und Cytosin-Arabinosid. Zweiundzwanzig Patienten wurden in strikter reverser Isolation mit antimikrobieller Dekontamination behandelt, 25 Patienten auf normalen Krankenstationen ohne Ma\nahmen zur Infektionsprophylaxe. Die HÄufigkeit neuer Infektionen pro Patient war 0,77 bei den isolierten Patienten und 1,42 in der Kontrollgruppe. Die Rate kompletter Remissionen betrug bei den isolierten Patienten 77% im Vergleich zu 56% bei den Patienten auf den normalen Krankenstationen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01008576
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  • 3
    Electronic Resource
    Electronic Resource
    High-dose cytosine arabinoside and daunorubicin postremission therapy in adults with de novo acute myeloid leukemia (1995)
    Springer
    Annals of hematology 71 (1995), S. 219-225 
    Details
    ISSN: 1432-0584
    Keywords: De novo AML ; Adults ; HD-Ara-C/DNR consolidation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A total of 149 consecutive de novo AML patients aged 50 years or less (median age = 37 years) were enrolled in this prospective multicenter trial initiated in May 1985. All patients received the same induction and early consolidation therapy with daunorubicin (DNR), cytosine arabinoside (Ara-C), and etoposide (DAV). High-dose Ara-C/DNR therapy included Ara-C at 3 g/m2, in 12 doses (HD-Ara-C/DNR I) and eight doses (HD-Ara-C/DNR II), followed by DNR 30 mg/m2 for 3 days. A complete remission (CR) was achieved in 104 (70%) patients; 61 complete responders received at least one cycle with HD-Ara-C/DNR. If those patients who were transplanted in first CR (n=26), were not considered, the median relapsefree-survival (MRFS) of the remaining 78 patients was 15 months, with a probability of relapse-free survival (RFS) at 116 months of 30% (95% CI, 20–40%) after a median follow-up of 95 months. The MRFS of the HD-Ara-C/DNR consolidated patients was 25 months, with a probability of RFS at 116 months of 37% (95% CI, 24–50%). If all patients who were transplanted (n=44) were not considered, the median survival time (MST) was 18 months with a probability of being alive at 118 months of 24% (95% CI, 16–33%). MST of the HD-Ara-C/DNR consolidated patients was 58 months with a survival probability of 46% (95% CI, 31–60%) at 118 months. Prognostic factor analysis did not reveal any significant influence of age, sex, FAB subtype, white blood cell count, hemoglobin level, thrombocyte count, LDH, or response to the first induction course on RFS of the HD-Ara-C/DNR consolidated patients. In summary, HD-Ara-C/DNR consolidation can improve the long-term outcome of a subgroup of de novo AML patients. Further improvement of the outcome seems to depend on the identification of patients with an inferior outcome under that strategy who might benefit from alternative treatment strategies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01744371
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    Paper (German National Licenses)
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