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Pneumonia in the Cancer Patient

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… The availability of voriconazole as primary therapy for invasive pulmonary aspergillosis [ 36 ] and caspofungin for salvage therapy of refractory invasive aspergillosis [ 37 ] is a promising addition to the antifungal armamentarium. … A preliminary study using various antifungal combinations hinted modest superiority of caspofungin plus voriconazole in HSCT recipients with invasive fungal infections [ 38 ]. …

Machine learning-based prognostic model for bloodstream infections in hematological malignancies using Th1/Th2 cytokines.

OBJECTIVE: Bloodstream infection (BSI) is a significant cause of mortality in patients with hematologic malignancies(HMs), particularly amid rising antibiotic resistance. This study aimed to analyze pathogen distribution, drug-resistance patterns and develop a novel predictive model for 30-day mortality in HM patients with BSIs. METHODS: A retrospective analysis of 231 HM patients with positive blood cultures was conducted. Logistic regression identified risk factors for 30-day mortality. Th1/Th2 cytokines were collected at BSI onset, with LASSO regression and restricted cubic spline analysis

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… Meanwhile, no fungus resistant to amphotericin B, caspofungin and micafungin was found in this study. … Resistance to voriconazole in fungal infections exceeded 50%, suggesting that alternatives such as amphotericin B, caspofungin, or micafungin should be considered for antifungal treatment. …

Epidemiology and Factors Associated with Treatment Success of Invasive Fungal Infections Among Newly Hematologic Malignancy Patients Receiving Chemotherapy or Hematopoietic Stem Cell Transplant in Thailand.

PurposeInvasive fungal infection (IFI) causes disability/death in patients with hematologic malignancy (HM) receiving chemotherapy or hematopoietic stem cell transplant (HSCT). There is limited epidemiological data, treatment outcomes, and factors associated with IFI treatment success in Thailand. This study aimed to identify factors associated with IFI treatment success among new HM patients receiving chemotherapy or HSCT, determine IFI incidence among HM patients receiving chemotherapy or HSCT, and the IFI incidence of a breakthrough in patients receiving primary antifungal prophylaxis, and

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… Table 4 The Data of Antifungal Susceptibility Testing (N = 12) Fungal Species (N) Test Minimum Inhibitory Concentration (mg/L) Amphotericin B Fluconazole Itraconazole Voriconazole Posaconazole Caspofungin Micafungin Anidulafungin 5-FU C. tropicalis (7) A 1 (S) A 0.38 (S) A 24 (R) 1.5 (R) 0.25 (S) A 0.25 … Fungal Species (N) | Test | Minimum Inhibitory Concentration (mg/L) Amphotericin B | Fluconazole | Itraconazole | Voriconazole | Posaconazole | Caspofungin | Micafungin | Anidulafungin | 5-FU C. tropicalis (7) | A | | 1 (S) | | | | | | | A | | 0.38 (S) | | | | | | | A | | 24 (R) | | …

Связанная с терапией острая миелоидная лейкемия после плазмы лейкемии: доклад по делу и литературный обзор.

С улучшением выживаемости в миеломе (ММ) связанная с терапией острая лейкемия миэлоида (t-AML) стала клинически значимой второй первичной халатностью (SPM). Мы сообщаем о случае превращения MM в T-AML после мультиагентной химиотерапии и анализируем литературу о связанных с терапией лейкемиях в MM. Мы сообщаем о случае пациента, у которого был диагностирован первичный лейкемия клеток плазмы (тип ИгГ-И, R-ISS стадия III), который достиг полной ремиссии после лечения с помощью даратумумаба, линалидомида и дексаметазона после получения режима лечения, основанного на протеатических ингибиторах. Пац

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… He developed persistent severe neutropenia, thrombocytopenia, and recurrent febrile episodes, treated with meropenem, caspofungin, and supportive transfusions. Outcome and Follow‐Up On July 31st, 2025, he experienced sudden loss of consciousness and left‐sided hemiplegia. …

Prophylaxis and Empirical Therapy of Infection in Cancer Patients

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A year in pharmacology: new drugs approved by the US Food and Drug Administration in 2023.

With 54 new drugs and seven cellular and gene therapy products, the approvals by the US Food and Drug Administration (FDA) recovered 2023 from the 2022 dent back to the levels of 2020-2021. As in previous years of this annual review, we assign these new drugs to one of three levels of innovation: first drug against a condition ("first-in-indication"), first drug using a novel molecular mechanism ("first-in-class"), and "next-in-class," i.e., a drug using an already exploited molecular mechanism. We identify four (7%) "first-in-indication," 22 (36%) "first-in-class," and 35 (57%) "next-in-class

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… Clinical studies have convincingly demonstrated the efficacy of rezafungin, showing non-inferiority to caspofungin for primary endpoints such as day-14 global cure and 30-day all-cause mortality. …

The Role of the Research Advanced Practice Provider in CAR T-Cell Clinical Trials.

In recent years, chimeric antigen receptor (CAR) T-cell therapy has emerged as an effective and potentially paradigm-shifting therapy for patients with refractory lymphoma and myeloma. This novel therapy involves engineering T cells to recognize specific antigens on the surface of cancer cells. Several CAR T-cell products are approved by the US Food and Drug Administration as a result of numerous clinical trials. Due to the complexity of these studies and the high level of care required for CAR T-cell therapy patients, the role of the research advanced practice provider (APP) has become increa

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… . | High risk includes patients with leukemia, recent allogeneic stem cell transplant, prior history of mold infection, neutropenia ≥ 14 days, or patients with grade 3 or 4 CRS/ICANS or who received ≥ 3 days of steroids | Caspofungin 50 mg IV daily Fungal prophylaxis (low-risk) | Fluconazole 200–400 … mg orally/IV daily | Start day of cell infusion and continue until ANC > 0.5 K/mL for 3 consecutive days without growth factor support | For patients who don't meet high-risk criteria for fungal infection Adjust for renal function | Caspofungin 50 mg IV daily Hypogammaglobulinemia | IVIG replacement …

Prognosis of invasive pulmonary aspergillosis in patients with hematologic diseases in Korea.

BackgroundThe aim of this study was to investigate therapeutic outcomes and assess factors associated with therapeutic outcomes in hematologic patients with invasive pulmonary aspergillosis (IPA).MethodsWe analyzed all consecutive cases of IPA in adults with hematologic diseases from January 2008 to January 2009 at a Catholic Hematopoietic Stem Cell Transplantation (HSCT) Center in Seoul, Korea.ResultsA total of 54 patients were identified. Underlying diseases were acute myelogenous leukemia (n=25), acute lymphoblastic leukemia (n=10), myelodysplastic syndrome (n=7), chronic myelogenous leukem

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… In cases of primary antifungal failure (n=46), intravenous VCZ (n=29) was the most common salvage antifungal agent followed by caspofungin (n=10), AMB (n=4), intravenous ITZ (n=2) and LAMB (n=1). None of the patients received combination antifungal treatment. …

Ocrelizumab-Induced Hemophagocytic Lymphohistiocytosis: A Case Report.

Hemophagocytic lymphohistiocytosis (HLH) is an uncommon disorder marked by severe immune system dysfunction and excessive inflammation. Its clinical features often mimic those of severe sepsis, including persistent high fevers, multiorgan failure, cytopenia, and coagulation abnormalities. HLH can be triggered by infections, malignancies, rheumatological disorders, genetic factors, and medications, particularly those that cause immunosuppression. Ocrelizumab, an anti-CD20 monoclonal antibody used in the treatment of multiple sclerosis, has been associated with rare immune-mediated complications

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… Antibiotics were escalated to meropenem, and caspofungin was added. Despite intensifying antibiotic therapy, her fever persisted, and she required oxygen supplementation the next day. …

Management of infection and ocular complications in pediatric SJS/TEN-like acute graft-versus-host disease: a clinical case study and literature review.

Acute graft-versus-host disease (aGVHD) with skin manifestations reminiscent of Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) is associated with poor outcomes. However, optimal management strategies to enhance quality of life in SJS/TEN-like aGVHD remain undefined. This study aims to investigate the management of complex infections and acute ocular injury in patients with SJS/TEN-like aGVHD following allogeneic hematopoietic stem cell transplantation. We conducted a comprehensive analysis of the treatment course for a patient with SJS/TEN-like aGVHD, complemented by a lit

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… Following a review of relevant literature and antifungal susceptibility testing, caspofungin was discontinued, and liposomal amphotericin B combined with voriconazole was initiated for antifungal therapy. … Despite the patient receiving prophylactic treatment with caspofungin, both fungi were identified as inherently resistant to this agent. …

Prophylaxis, diagnosis and therapy of infections in patients undergoing high-dose chemotherapy and autologous haematopoietic stem cell transplantation. 2020 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO).

To ensure the safety of high-dose chemotherapy and autologous stem cell transplantation (HDC/ASCT), evidence-based recommendations on infectious complications after HDC/ASCT are given. This guideline not only focuses on patients with haematological malignancies but also addresses the specifics of HDC/ASCT patients with solid tumours or autoimmune disorders. In addition to HBV and HCV, HEV screening is nowadays mandatory prior to ASCT. For patients with HBs antigen and/or anti-HBc antibody positivity, HBV nucleic acid testing is strongly recommended for 6 months after HDC/ASCT or for the durati

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… For second-line empiric antifungal therapy, caspofungin or liposomal amphotericin B are preferred, while conventional amphotericin B deoxycholate is not recommended due to an unfavourable toxicity profile. Recommendations on empiric antimicrobial therapy are summarized in Table 5 . … Caspofungin versus liposomal amphotericin B for empirical antifungal therapy in patients with persistent fever and neutropenia. N Engl J Med. 2004;351(14):1391–1402. doi: 10.1056/NEJMoa040446. 133. …

C-Reactive Protein Monitoring and Clinical Presentation of Fever as Predictive Factors of Prolonged Febrile Neutropenia and Blood Culture Positivity after Autologous Hematopoietic Stem Cell Transplantation-Single-Center Real-Life Experience.

BackgroundFebrile neutropenia (FN) is a medical emergency that requires urgent evaluation, timely administration of empiric broad-spectrum antibiotics and careful monitoring in order to optimize the patient's outcome, especially in the setting of both allogeneic and autologous hematopoietic stem cell transplant (ASCT).MethodsIn this real-life retrospective study, a total of 49 consecutive episodes of FN were evaluated in 40 adult patients affected by either multiple myeloma (thirty-eight) or lymphoma (eleven), following ASCT, with nine patients having fever in both of the tandem transplantatio

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… Antifungal treatment with caspofungin and isavuconazole was used in two patients each, due to suspected fungal infection. 3.5. …

Drug assessment by a Pharmacy and Therapeutics committee: from drug selection criteria to use in clinical practice.

BackgroundIn Spain, hospital medicines are assessed and selected by local Pharmacy and Therapeutics committees (PTCs). Of all the drugs assessed, cancer drugs are particularly important because of their budgetary impact and the sometimes arguable added value with respect to existing alternatives. This study analyzed the PTC drug selection process and the main objective was to evaluate the degree of compliance of prescriptions for oncology drugs with their criteria for use.MethodsThis was a retrospective observational study (May 2007 to April 2010) of PTC-assessed drugs. The variables measured

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… acid-osteoporosis (M05BA) | May 2009 to April 2010 | Levobupivacaine (N01BB) | Natalizumab (L04AA) | Purified botulinum toxin type A (M03AX) | Sulpur hexafluoride (V08DA) | Zoledronic acid-bone metastases (M05BA) | Thyrotropin alfa (V04CJ) | | Fosamprenavir (J05AE) | | Voriconazole (J02AC) | | Caspofungin …

Allogeneic hematopoietic cell transplantation with non-myeloablative conditioning for patients with hematologic malignancies: Improved outcomes over two decades.

We have used a non-myeloablative conditioning regimen for allogeneic hematopoietic cell transplantation for the past twenty years. During that period, changes in clinical practice have been aimed at reducing morbidity and mortality from infections, organ toxicity, and graft-versus-host disease. We hypothesized that improvements in clinical practice led to better transplantation outcomes over time. From 1997-2017, 1,720 patients with hematologic malignancies received low-dose total body irradiation +/- fludarabine or clofarabine before transplantation from HLA-matched sibling or unrelated donor

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… An early CT-diagnosis-based treatment strategy for invasive fungal infection in allogeneic transplant recipients using caspofungin first line: an effective strategy with low mortality. Bone Marrow Transplant. 2009; 44(1):51-56. 34. Monaco F, Scott BL, Chauncey TR, et al. …

Экулизумаб для связанной с АТКР тромботической микроангиопатии в китайском реципиенте трансплантации почек с типом 2 диабет: отчет по делу.

ЦЕЛЬ: Данное исследование было направлено на изучение эффективности экулизумаба в лечении недавно разработанной тромботической микроангиопатии (TMA), связанной с острым отторжением с помощью Т-клеток (ATCR) у пациентов с типом 2 диабет после трансплантации почек. МЕТОДЫ: Новая тромботическая микроангиопатия после трансплантации почек является относительно редким, но серьезным осложнением, которое клинически трудно уладить и требует своевременного вмешательства для предотвращения пересадки или ранней потери трансплантатата. В настоящее время в клинической практике отсутствует консенсус в отноше

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… The infection was resolved with a combination of antimicrobial therapy ( Figure 2b ), including piperacillin-tazobactam (4.5 g three times daily for two weeks), caspofungin (50 mg daily for 15 days), trimethoprim-sulfamethoxazole (0.96 g twice daily for 15 days), ganciclovir (0.25 g twice daily for two …

Treatment of relapsed or refractory Hodgkin's lymphoma with lenalidomide combined with PD-1 monoclonal antibody: a case report and literature review.

The current standard treatment for relapsed or refractory Hodgkin's lymphoma involves salvage chemotherapy followed by high-dose chemotherapy and sequential autologous stem cell transplantation. However, for patients who cannot tolerate intense chemotherapy or do not meet the conditions for autologous stem cell transplantation, there is a need to explore new treatment options. We report a case of an elderly patient with multiple relapses of classical Hodgkin's lymphoma who experienced repeated disease progression despite undergoing multiple lines of treatment including novel agents such as CD3

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… From May 10th, 2020, the patient was treated with caspofungin combined with cefoperazone-sulbactam for anti-infective therapy. Although the intervals between fever episodes became longer, and the peak temperature decreased, the patient still experienced persistent fever. …

Incidence and risk factors of opportunistic infections after autologous stem cell transplantation: a nationwide, population-based cohort study in Korea.

Several guidelines classify autologous stem cell transplantation (ASCT) as a low to intermediate risk group for infection. In a nationwide population-based study, using the Korean Health Insurance Review and Assessment Service database, patients with lymphoma and multiple myeloma (MM) who underwent ASCT from 2002 to 2016 were retrospectively analyzed. Cumulative incidence rates (CIRs) and risk factors of opportunistic infections were investigated. CIRs of fungal, Varicella zoster virus (VZV), cytomegalovirus (CMV), and Pneumocystis jirovecii infections in lymphoma were 7.9%, 16.0%, 7.4%, and 5

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… Fungal infections were defined as invasive candidiasis and aspergillosis, or cases in which antifungal agents such as intravenous (IV) amphotericin B, IV liposomal amphotericin B, IV caspofungin, IV itraconazole, IV voriconazole, and IV fluconazole were prescribed for more than 7 days. …

Comprehensive Treatment of Hematological Patients with SARS-CoV-2 Infection Including Anti-SARS-CoV-2 Monoclonal Antibodies: A Single-Center Experience Case Series.

Patients with hematologic malignancies are at high risk of exacerbated condition and higher mortality from coronavirus disease 2019 (COVID-19). Bamlanivimab, casirivimab/imdevimab combination, and sotrovimab are monoclonal antibodies (mABs) that can reduce the risk of COVID-19-related hospitalization. Clinical effectiveness of bamlanivimab and casirivimab/imdevimab combination has been shown for the Delta variant (B.1.617.2), but the effectiveness of the latter treatment against the Omicron variant (B.1.1.529) has been suggested to be reduced. However, the tolerability and clinical usage of se

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… At the transferring hospital, she had already received dexamethasone (6 mg for 10 days) as well as an anti-infective therapy with piperacillin/tazobactam, meropenem, and caspofungin. Bronchoalveolar lavage did not point to superinfection. Chest CT scan showed typical COVID-19 infiltrations. …

Clinical course and end-of-life care in patients who have died after allogeneic stem cell transplantation.

PURPOSE: Allogeneic stem cell transplantation may cure approximately 50% of patients, however, a significant part of the other half might benefit from a high-quality palliative care medicine at the end of life. Somatic, psychic and spiritual needs of these patients may differ from those of patients suffering from incurable solid tumours and are not comprehensively evaluated so far. METHODS: To address this question, data from charts of 123 patients who have died after allogeneic stem cell transplantation were extracted. In detail, the time line of the clinical course, the symptoms, the admini

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… Clin Infect Dis 34(7):909–917 Mora-Duarte J, Betts R, Rotstein C, Colombo AL, Thompson-Moya L, Smietana J et al (2002) Comparison of caspofungin and amphotericin B for invasive candidiasis. …

Stem Cell Transplantation

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… Micafungin has also been found to be effective in the prevention of Candida infections after HCT [ 70 ] and caspofungin has been found to be effective in patients with neutropenia after treatment for hematologic malignancies [ 71 ]. … Mattiuzzi GN Alvarado G Giles FJ Ostrosky-Zeichner L Cortes J O’brien S Verstovsek S Faderl S Zhou X Raad II Bekele BN Leitz GJ Lopez-Roman I Estey EH Open-label, randomized comparison of itraconazole versus caspofungin for prophylaxis in patients with hematologic malignancies Antimicrob Agents Chemother …