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Цитомегаловирус возрождается под упреждающей терапией после пересадки стволовых клеток аллогенной гематополией: структура, выживание и факторы риска в Республике Корея.

ВВЕДЕНИЕ: Для ретрансплантации цитомегаловируса (CMV) использовалась упреждающая терапия при трансплантации стволовых клеток с использованием аллогенетической гематополиетической гемоглобы (алло-HSCT). Неясно, имеет ли эта стратегия более низкие клинические результаты в районах, эндемичных для ВИЧ, и требуется ли более агрессивная профилактика. МЕТОДЫ: Мы ретроспективно проанализировали модели и выживаемость после возобновления КМВ у пациентов, проходящих упреждающую терапию после алло-ХСХТ, и провели оценку пациентов с высокой степенью риска, которые могли бы извлечь пользу из агрессивной про

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… received cyclosporine (3 mg/kg of body weight) or tacrolimus (0.03 mg/kg of body weight) combined with methotrexate (15 mg/m 2 of BSA on day 1 and 10 mg/m 2 on days 3, 6, and 11) for graft-versus-host disease (GVHD) prophylaxis, and levofloxacin (500 mg, once daily), acyclovir (400 mg, twice daily), micafungin …

Bloodstream infections in patients with hematological malignancies: which is more fatal - cancer or resistant pathogens?

BackgroundThe primary objective of this study was to report the incidence of bloodstream infections (BSIs) and clinically or microbiologically proven bacterial or fungal BSIs during neutropenic episodes in patients with hematological malignancies.MethodsIn this retrospective observational study, all patients in the hematology department older than 14 years who developed febrile neutropenia during chemotherapy for hematological cancers were evaluated. Patients were included if they had experienced at least one neutropenic episode between November 2010 and November 2012 due to chemotherapy in th

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… Voriconazole and micafungin were reported to be successful treatment regimens. 47 BSIs, which commonly occur during febrile neutropenic episodes by GNB in patients with hematological malignancies should be treated with non-carbapenem-based antip-seudomonal antibiotic initially taking into consideration …

Management of Adverse Reactions for BCMA-Directed Therapy in Relapsed Multiple Myeloma: A Focused Review.

Anti-B-cell maturation antigen therapies consisting of bispecific antibodies, antibody-drug conjugates, and chimeric antigen receptor T cells have shown promising results in relapsed refractory multiple myeloma (RRMM). However, the severe side effects include cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome, cytopenia(s), infections, hemophagocytic lymphohistiocytosis, and organ toxicity, which could sometimes be life-threatening. This review focuses on these most common complications post-BCMA therapy. We discussed the risk factors, pathogenesis, clinical feat

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… Antifungal prophylaxis, such as fluconazole 200 mg daily or micafungin 50 mg IV daily in fluconazole-contraindicated cases, to be given during periods of prolonged and recurrent neutropenia. …

Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country.

BackgroundFebrile neutropenia (FN) is a life-threatening complication that predisposes cancer patients to serious infections. This study aims to describe the epidemiology and source of infection in cancer patients with FN in a tertiary care hospital.MethodsA hospital-based retrospective study was conducted in a large tertiary care hospital from January 2020 to December 2021. Data on cancer patients with FN were collected from the hospital information system.Results150 cancer patients with FN were identified during the study period. Most patients were males (98; 65.3%), and the mean age of part

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… (100) | – | – | 0 | – Pseudomonas stutzeri | – | – | 0 | 0 | 0 | 0 | 0 | – | 0 | – Antimicrobial resistance in fungal isolates Two fungal species were isolated throughout our study; one was C. tropicalis, which was found to be sensitive to caspofungin, fluconazole, flucytosine, voriconazole, and micafungin …

Candida and candidaemia. Susceptibility and epidemiology.

In our part of the world invasive fungal infections include invasive yeast infections with Candida as the absolutely dominating pathogen and … c breakpoints were selected. Moreover, the issues of caspofungin variability and of overlap between micafungin MICs for wild type and mutant C. glabrata populations were handled and understood. Anidulafungin EUCAST breakpoints are now published and publically available at the www.eucast.org website and anidulafungin testing recommended as a marker for the ec …

Management of Invasive Pulmonary Aspergillosis in Intensive Care Units: Guidelines From the Fungal Infection Network of Switzerland (FUNGINOS).

Invasive pulmonary aspergillosis (IPA) is increasingly recognised in intensive care units (ICU) affecting not only patients with classical immunosuppressive conditions but also other severely ill patients, including those with respiratory viral infections (influenza, COVID-19), advanced chronic obstructive pulmonary disease or acute and chronic liver diseases. Several expert panels have proposed definitions of IPA in different ICU settings. However, practical recommendations for its diagnostic and therapeutic approaches are scarce. Moreover, these approaches can be influenced by different para

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… Amphotericin B deoxycholate is not recommended due to toxicity. d Caspofungin or anidulafungin (micafungin has limited availability in Switzerland). e Voriconazole, isavuconazole or posaconazole. f Examples where combined triazole and echinocandin therapy may be considered: patients with hematologic …

Seamless Navigation of Bispecific Therapies: Optimizing Management and Outpatient Access With a Focus on Coordination.

Bispecific antibodies (BsAbs) have emerged as crucial therapeutic agents for patients with relapsed/refractory diffuse large B-cell lymphoma, multiple myeloma, and most recently, lung cancer. These therapies have demonstrated remarkable efficacy in clinical trials; however, multidisciplinary collaboration is essential to ensure optimal patient outcomes amid the operational complexities associated with BsAb therapy. As BsAbs are being prepared for broader adoption, clinicians and treatment centers must navigate operational challenges, including financial considerations, patient selection, careg

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… risk Patients at low risk for invasive mold infections should receive prophylaxis with the following agents targeting Candida Preferred Fluconazole a , d 200-400 mg po/IV daily Alternatives Consider when patient unable to tolerate fluconazole due to liver dysfunction, QTc prolongations, and/or DDIs Micafungin …

Infections associated with CAR-T cell therapy in patients with relapsed refractory multiple myeloma: Risks and prevention strategies.

BackgroundChimeric antigen receptor T (CAR-T) cell therapy has emerged as a potent treatment for relapsed or refractory multiple myeloma, demonstrating significant clinical efficacy. Despite these advances, treatment-related toxicities, particularly infections, pose a significant challenge to patient safety.MethodsThis review synthesizes current knowledge on the mechanisms underlying post-CAR-T therapy infections, focusing on the interplay between immune dysfunction, host factors, and treatment-induced toxicity. It provides a comprehensive analysis of the temporal and individual variability in

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… in some high‐risk patients with fungal infections who develop chronic granulocytopenia or who take chronic systemic corticosteroids for adverse events related to CAR‐T cell therapy. 57 , 69 Prophylactic antifungal infection treatment with azoles (e.g., posaconazole, fluconazole, or voriconazole) and micafungin …

Use of short interfering RNA delivered by cationic liposomes to enable efficient down-regulation of PTPN22 gene in human T lymphocytes.

Type 1 diabetes and thyroid disease are T cell-dependent autoimmune endocrinopathies. The standard substitutive administration of the deficient hormones does not halt the autoimmune process; therefore, development of immunotherapies aiming to preserve the residual hormonal cells, is of crucial importance. PTPN22 C1858T mutation encoding for the R620W lymphoid tyrosine phosphatase variant, plays a potential pathophysiological role in autoimmunity. The PTPN22 encoded protein Lyp is a negative regulator of T cell antigen receptor signaling; R620W variant, leading to a gain of function with parado

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… Successful treatment of rhino-orbital mucormycosis by a new combination therapy with liposomal amphotericin B and micafungin. Auris Nasus Larynx 2012; 39: 224–228. doi: 10.1016/j.anl.2011.03.006 36. Joly F, Ray-Coquard I, Fabbro M, Donoghoe M, Boman K, Sugimoto A, et al. …

Prophylaxis and Empirical Therapy of Infection in Cancer Patients

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Proceedings of Réanimation 2020, the French Intensive Care Society International Congress.

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50th ESCP Symposium on Clinical Pharmacy, Polypharmacy and ageing - highly individualized, interprofessional, person-centered care : 19–21 October 2022, Prague, Czech Republic

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Регулирование заразительных осложнений в создании химической антигенной приемной клетки (CAR-T)

Химерическая антигенная рецепторная T-клетка (CAR T-клетка) изменила парадигму управления лимфомой не Ходжкина (NHL) и множественной миеломой. Осложнения, связанные с инфекцией, стали предметом озабоченности, которая может возникнуть в процессе лечения и привести к заболеваемости и смертности. В ходе этого обзора мы классифицировали осложнения, связанные с инфекцией, в three Категория, этап предварительного вливания с момента предварительного лимфодерации (LD) до дня zero, ранний этап от дня вливания до дня 30 после введения в эксплуатацию и с запозданием изо дня в день 30 и дальше. Инфекции,

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… 500/mm 3 ) Antiviral ( for HSV/VZV prevention) | Acyclovir 400-800mg PO BID | Valacyclovir 500mg PO daily Famciclovir 250mg PO BID | Start with lymphodepletion | Continue until CD4 counts > 200 or at least 6 months Antifungals | Fluconazole 200mg PO daily (standard risk) Posaconazole 300mg PO daily | Micafungin …

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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… Infectious Diseases Mycoses Study G Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation. Clin Infect Dis. 2004;39(10):1407–1416. doi: 10.1086/422312. 64. …

Optimizing the Clinical Impact of CAR-T Cell Therapy in B-Cell Acute Lymphoblastic Leukemia: Looking Back While Moving Forward.

Chimeric antigen receptor T-cell (CAR-T) therapy has been successful in creating extraordinary clinical outcomes in the treatment of hematologic malignancies including relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). With several FDA approvals, CAR-T therapy is recognized as an alternative treatment option for particular patients with certain conditions of B-ALL, diffuse large B-cell lymphoma, mantle cell lymphoma, follicular lymphoma, or multiple myeloma. However, CAR-T therapy for B-ALL can be surrounded by challenges such as various adverse events including the life

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… Similarly, antifungal prophylaxis such as micafungin or fluconazole for Candida species in patients with neutropenia and pentamidine or sulfamethoxazole for Pneumocystis jiroveci are among common recommendations for fungal infection prevention ( 25 , 164 , 165 ). …

Overview of infectious complications among CAR T- cell therapy recipients.

Chimeric antigen receptor-modified T cell (CAR T-cell) therapy has revolutionized the management of hematological malignancies. In addition to impressive malignancy-related outcomes, CAR T-cell therapy has significant toxicity-related adverse events, including cytokine release syndrome (CRS), immune effector cell associated neurotoxicity syndrome (ICANS), immune effector cell-associated hematotoxicity (ICAHT), and opportunistic infections. Different CAR T-cell targets have different epidemiology and risk factors for infection, and these targets result in different long-term immunodeficiency st

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… | Agent | Alternative agent (s) | Comment Antibacterial | Levofloxacin | | Start when ANC < 500 and continue until neutrophil recovery (ANC >500 for at least 3 days) Antifungal | Fluconazole | Micafungin | Start when ANC<500 and continue until neutrophil recovery (ANC >500 for at least 3 days) Anti-mold …

Clinical Manifestations of Human Exposure to Fungi.

Biological particles, along with inorganic gaseous and particulate pollutants, constitute an ever-present component of the atmosphere and surfaces. Among these particles are fungal species colonizing almost all ecosystems, including the human body. Although inoffensive to most people, fungi can be responsible for several health problems, such as allergic fungal diseases and fungal infections. Worldwide fungal disease incidence is increasing, with new emerging fungal diseases appearing yearly. Reasons for this increase are the expansion of life expectancy, the number of immunocompromised patien

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… Treatment of Systemic Mycoses Treatments for these severe systemic fungal infections include systemic azole agents (itraconazole, fluconazole, voriconazole, isavuconazole, and posaconazole), echinocandins (caspofungin, micafungin, anidulafungin, rezafungin), antimetabolites (flucytosine) or polyene …

Evolving strategies for addressing CAR T-cell toxicities.

The field of chimeric antigen receptor (CAR) T-cell therapy has grown from a fully experimental concept to now boasting a multitude of treatments including six FDA-approved products targeting various hematologic malignancies. Yet, along with their efficacy, these therapies come with side effects requiring timely and thoughtful interventions. In this review, we discuss the most common toxicities associated with CAR T-cells to date, highlighting risk factors, prognostication, implications for critical care management, patient experience optimization, and ongoing work in the field of toxicity mit

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… assessments for early symptom detection Early and aggressive CRS/ICANS treatment [ 15 ] Infections Key references [ 16 ] Grading per CTCAE for study reporting Prophylaxis Bacterial : fluoroquinolones for ANC < 0.5 × 109/L Viral : acyclovir or valacyclovir, from LD to 6 months post-CAR Fungal : fluconazole or micafungin … for early symptom detection Early and aggressive CRS/ICANS treatment [ 15 ] Infections Key references [ 16 ] | Grading per CTCAE for study reporting | Prophylaxis Bacterial : fluoroquinolones for ANC < 0.5 × 109/L Viral : acyclovir or valacyclovir, from LD to 6 months post-CAR Fungal : fluconazole or micafungin …

Critically Ill Immunosuppressed Host

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… fluconazole would be less attractive either because the patient has received fluconazole prophylaxis or because molds are suspected. 28 , 38 , 39 The toxicity profile of amphotericin B, even in its liposomal form, has led many clinicians to prefer voriconazole or one of the echinocandins (i.e., caspofungin, micafungin …

The 44th Annual Meeting of the European Society for Blood and Marrow Transplantation: Physicians Poster Sessions

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