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  • 1
    Electronic Resource
    Electronic Resource
    Knochenmarktransplantation bei Panmyelopathie, akuter Leukämie und chronisch myeloischer Leukämie: Ergebnisse der „Ulmer Transplantationsgruppe“ (1984)
    Springer
    Journal of molecular medicine 62 (1984), S. 577-585 
    Details
    ISSN: 1432-1440
    Keywords: Bone marrow transplantation ; Aplastic anaemia ; Acute leukaemia ; Chronic granulocytic leukaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary From 1972–1983 53 patients underwent bone marrow transplantation. The median age was 18 years (3–41). 27 patients suffered from severe aplastic anaemia, 22 patients had acute leukaemia and 4 patients had chronic granulocytic leukaemia in chronic phase. Out of 22 patients with acute leukaemia, 2 had florid leukaemia, 2 had an early relapse and 18 patients were in first or second remission of their disease. 2/53 patients received a syngeneic transplant, 51/53 patients an allogeneic transplant. 47/51 patients had a HLA-A, B, C-identical, MLC-negative sibling donor, 1/51 had a HLA-A, B-C-identical, MLC-positive sibling donor, 2/51 a HLA-phaenotypical identical parental donor and 1/51 a HLA-identical, MLC-negative unrelated donor. The comparison of the results obtained in patients with severe aplastic anaemia transplanted from 1972–1979 with those transplanted from 1980–1983 shows that the bone marrow transplantation has to be performed in an early stage of the disease before the patients become multiple transfused, sensitized and severely infected and that the conditioning regimen for polytransfused patients has to be more intensive than in untransfused patients. From the patient group transplanted 1972–1979, only 1/14 patients is a long-term survivor in contrast to 8/13 patients transplanted from 1980–1983. 11/22 patients with acute leukaemia are alive between more than 5 years and 14 days after bone marrow transplantation. Only 1/4 patients, who were transplanted not in remission, is alive. For patients with acute leukaemia the bone marrow transplantation should be performed in an early stage of their disease when the tumor burden is small and when the patients are in good clinical condition. 2/4 patients with CGL are alive between 12 months and 3 months after bone marrow transplantation. In our patient group graft versus host disease was the most important problem with a high mortality due to GvHD associated infections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728176
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  • 2
    Electronic Resource
    Electronic Resource
    A simple technique for processing of bone marrow for human marrow transplantation (1982)
    Springer
    Annals of hematology 45 (1982), S. 411-414 
    Details
    ISSN: 1432-0584
    Keywords: Bone marrow transplantation ; Processing of bone marrow
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A simple stainless steel device is described for the processing of marrow for intravenous infusion to marrow graft recipients. The device can be cleaned easily and sterilized for re-use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320552
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  • 3
    Electronic Resource
    Electronic Resource
    European experience in bone marrow transplantation (1983)
    Springer
    Annals of hematology 46 (1983), S. 355-358 
    Details
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00320696
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  • 4
    Electronic Resource
    Electronic Resource
    Low incidence of invasive fungal infections after bone marrow transplantation in patients receiving amphotericin B inhalations during neutropenia (1994)
    Springer
    Annals of hematology 68 (1994), S. 21-26 
    Details
    ISSN: 1432-0584
    Keywords: Fungal infection ; Bone marrow transplantation ; Amphotericin B inhalations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The incidence of invasive fungal infections after bone marrow transplantation (BMT) was analyzed in 303 consecutive marrow graft recipients (allogeneicn=271, autologousn=27, syngeneicn=5). All patients received inhalations with amphotericin B (10 mg twice daily) during neutropenia. The overall incidence of invasive fungal infections within the first 120 days after transplant was 3.6% (11/303; aspergillosis: 6; yeast infection: 5). Four of the 11 cases occurred early, and seven cases were observed after neutrophil recovery and discontinuation of amphotericin B inhalation treatment. Late infection was significantly associated with the development of acute graft-versus-host disease. Four of the 11 infections (early 2/4; late: 2/7) were observed in patients with a history of previous fungal infection. Other patient and treatment characteristics were not helpful in defining potential risk factors. In particular, the incidence of invasive fungal infections did not differ between patients with more or less strict reverse isolation measures. Occasional side effects such as initial mild cough and bad taste were rare, usually disappeared during continued administration, and were in no case the reason for discontinuation of treatment. These data suggest that aerosolized amphotericin B may be a useful, convenient, and efficient prophylactic antifungal regimen in BMT.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695915
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  • 5
    Electronic Resource
    Electronic Resource
    Thrombotic thrombocytopenic purpura in early pregnancy with maternal and fetal survival (1992)
    Springer
    Annals of hematology 64 (1992), S. 245-248 
    Details
    ISSN: 1432-0584
    Keywords: Thrombotic thrombocytopenic purpura ; Pregnancy ; Plasma exchange ; Plasma infusions ; Antiplatelet agents
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thrombotic thrombocytopenic purpura (TTP) is a hematologic disorder which is clinically characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neurologic symptoms, and cardiac and renal involvement. The pathogenic mechanisms of this disease are poorly understood. It is well known that TTP is associated with pregnancy and that prognosis for the mother and child is poor. We present the first case of a severe TTP diagnosed in the first trimester of pregnancy (13th week of gestation) with maternal survival and birth of a healthy child which required continuous and intensive treatment with plasmatherapy until delivery. During a period of 24 weeks several attempts to discontinue plasma therapy failed because of continuous active disease, and it became evident that plasma infusions were not as effective as plasma exchanges. The fact that the patient entered into remission soon after delivery of a healthy child by cesarean section in the 37th gestational week shows that in this case pregnancy activated an unknown factor which does not cross the placenta and which can be removed by plasmapheresis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01738304
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  • 6
    Electronic Resource
    Electronic Resource
    Infectious complications after allogeneic bone marrow transplantation with and without T-cell depletion of donor marrow (1989)
    Springer
    Infection 17 (1989), S. 124-130 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei 67 erwachsenen Patienten wurden die Infektkomplikationen nach allogener Knochenmarktransplantation (KMT) während verschiedener Zeitintervalle (Tag 0 bis Tag 30, 31 bis 100, 101 bis 365, 366 bis 730) untersucht. Siebenundzwanzig Patienten erhielten ein Transplantat ohne T-Zell-Depletion (TCD) unter Verwendung von Methotrexat oder Cyclosporin A als Prophylaxe einer Graftversus-Host-Reaktion (GvHD) und 40 Patienten ein Transplantat mit TCD durch Einsatz des monoklonalen Lymphozyten-Antikörpers Campath-1 und humanem Komplement. Die TCD verminderte Häufigkeit und Schweregrad der GvHD signifikant (p〈0.01), war aber mit einer erhöhten Transplantatabstoßung verknüpft. Während der verschiedenen Zeitintervalle hatten Patienten mit TCD eine ähnliche, niedrigere oder statistisch signifikant niedrigere Anzahl von bakteriellen, mykotischen oder viralen Infektionen und außerdem eine statistisch signifikant niedrigere Anzahl von tödlichen Infektionen (p=0.05) im Vergleich zu Patienten ohne TCD.
    Notes: Summary The infectious complications during different time intervals after allogeneic bone marrow transplantation (BMT) (day 0 to day 30, 31 to 100, 101 to 365, 366 to 730) were reviewed in 67 adult patients, 27 of whom received transplants without T-cell depletion (TCD) using methotrexate or cyclosporin A for prophylaxis of graft-versus-host disease (GvHD) and 40 of whom received donor marrow with TCD using the monoclonal anti-lymphocyte antibody campath-1 and human complement. The use of TCD reduced the incidence and severity of GvHD significantly (p〈0.01), but was associated with an increased rate of graft rejections. During all time intervals patients with TCD had a similar, lower or statistically significantly lower number of bacterial, fungal or viral infections and a statistically significantly lower number of lethal infections (p=0.05) as compared with patients without TCD. This finding might be explained by the fact that with TCD immunological reconstitution can take place unimpaired by GvHD or its prophylaxis or treatment, resulting in a decreased incidence of infections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01644010
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  • 7
    Electronic Resource
    Electronic Resource
    Corynebacterium jeikeium bacteremia at a tertiary care center (1991)
    Springer
    Infection 19 (1991), S. 201-204 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung In einer Universitätsklinik wurde während eines Zeitraumes von sechs Jahren bei 23 PatientenCorynebacterium jeikeium aus Blutkulturen isoliert.C. jeikeium-Bakteriämien traten weder zeitlich noch örtlich gehäuft auf. Die retrospektive Analyse der Patientendaten zeigte, daß in den meisten Fällen eine maligne hämatologische Grunderkrankung mit Neutropenie vorlag, ein zentral-venöser Katheter implantiert und eine antibiotische Therapie vorausgegangen war. Die Patientenpopulation mit nur einer positiven Blutkultur unterschied sich in wichtigen Aspekten von derjenigen mit mehreren positiven Blutkulturen. So waren Patienten mit nur einer positiven Blutkultur seltener an akuter Leukämie erkrankt, hatten signifikant höhere neutrophile Granulozytenkonzentrationen im peripheren Blut und waren zuvor über einen kürzeren Zeitraum antibiotisch behandelt worden. Weiterhin fanden sich in dieser Patientengruppe in allen Fällen andere mögliche Ursachen der Fieberepisoden. Auch die Mortalität war deutlich geringer. Trotz des zunehmend häufigeren Nachweises vonCorynebacterium jeikeium in Blutkulturen bleiben schwere Infektionen durch diesen Erreger weiterhin meist auf die Patientenpopulation mit hämatologischer Grunderkrankung und Neutropenie beschränkt.
    Notes: Summary During a six-year period 23 patients with isolation ofCorynebacterium jeikeium (formerly known asCorynebacterium group JK) from one or more blood cultures at a university hospital were identified. Cases occurred sporadically without time- or ward-related clustering. Review of the cases showed that most infections were nosocomial, that most of the patients had underlying malignant disease, had a chronic intravascular catheter implanted, had been pretreated with antibiotics, and were neutropenic at the time the blood cultures were drawn. Patients with only one versus those with more than one positive blood culture differed in some important aspects. Patients with only one positive blood culture were less likely to have acute leukemia, had significantly higher neutrophil counts and a shorter duration of preceding antibiotic treatment, and all had other probable causes of infection and fever. The mortality also appeared to be lower in these patients. Despite the possibility of increasing frequency of blood cultures positive forC. jeikeium, severe infections due to this organism continue to be largely confined to neutropenic patients with hematologic malignancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01644945
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  • 8
    Electronic Resource
    Electronic Resource
    Streptococcal bacteremia in adult patients with leukemia undergoing aggressive chemotherapy. A review of 55 cases (1990)
    Springer
    Infection 18 (1990), S. 138-145 
    Details
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die vorliegende Arbeit analysiert 55 Fälle von Streptokokken-Bakteriämie bei erwachsenen Patienten nach aggressiver antileukämischer Chemotherapie. Vergrünende Streptokokken waren die häufigsten Erreger (45 Isolate). Beta-hämolysierende Streptokokken (vier Isolate), Pneumokokken (drei Isolate) und Enterokokken (drei Isolate) waren dagegen eher selten. Klinisch waren die Infektionen gekennzeichnet durch Fieber, Beteiligung des oberen und unteren Respirationstrakts, Weichteilinfektion, durch Atemnotsyndrom und septischen Schock. 40 Patienten, bei denen ausschließlich Streptokokken in der Blutkultur nachgewiesen wurden, wurden verglichen mit 36 Patienten (ausgewählt nach denselben Kriterien) mit gramnegativer bakteriämischer Infektion. Die Gegenüberstellung ergab, daß Patienten mit Streptokokken-Bakteriämien häufiger hochdosiertes Cytosin-Arabinosid erhalten hatten (17 versus fünf Tage), eine längere Fieberdauer hatten (11 versus sieben Tage, P〈0.01), etwas länger antibakterielle Therapie benötigten (15 versus zwölf Tage, P=0.07, nicht signifikant) und häufiger mit Fluorochinolonen zur Infektprophylaxe behandelt waren (30 versus acht). Beide Gruppen unterschieden sich nicht hinsichtlich Alter, Grunderkrankung, Dauer der Granulozytopenie und Häufigkeit von Superinfektionen. Die Letalität betrug 18% bei Streptokokken-Bakteriämie und 17% bei Gram-negativer Bakteriämie. Die Untersuchung zeigt, daß Streptokokken, besonders vergrünende Streptokokken, ungewöhnlich häufig unerwartet schwere Infektionen bei Patienten nach antileukämischer Chemotherapie verursachen können.
    Notes: Summary We reviewed 55 cases of streptococcal bacteremia in adult patients who received cytotoxic chemotherapy for treatment of acute leukemia. Viridans group streptococci were the most frequent species isolated (45 isolates). Hemolytic streptococci (four isolates), pneumococci (three isolates), and enterococci (three isolates) were infrequent. Clinical features of streptococcal bacteremia included fever, upper and lower respiratory infection, respiratory distress syndrome, soft tissue infection, and septic shock. Forty patients who had only streptococci, but no other organisms isolated from their blood, were compared with 36 cases of gram-negative bacillary bacteremia that occurred during the same study period within the same population at risk. The comparison showed that patients with streptococcal bacteremia had more often received high dose cytosine arabinoside as part of their chemotherapy (17 vs. five), had a longer mean duration of fever (11 vs. seven days, p〈0.01) needed slightly more days of antibacterial therapy (15 vs. 12 days, p=0.07, not significant), and were more likely to have been treated with newer quinolones for infection prevention (30 vs. eight). No differences between both groups were found for age, underlying disease, remission status, duration of severe granulocytopenia, and number of superinfections. The overall mortality was 18% in streptococcal bacteremia and 17% in gram-negative bacillary bacteremia. Streptococci, especially viridans group streptococci, should now be regarded as frequent causes of serious life-threatening infections following aggressive chemotherapy in patients with hematologic malignancies.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01642101
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