• Title/Summary/Keyword: Neutropenia

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Effect of Molybdenum Induced Copper Deficiency on Peripheral Blood Cells and Bone Marrow in Buffalo Calves

  • Randhawa, C.S.;Randhawa, S.S.;Sood, N.K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.15 no.4
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    • pp.509-515
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    • 2002
  • Copper deficiency was induced in eight male buffalo calves by adding molybdenum (30 ppm wet basis) to their diet. Copper status was monitored from the liver copper concentration and a level below 30 ppm (DM basis) was considered as deficient. Haemoglobin, haematocrit, total and differential leucocyte numbers were determined. The functions of peripheral neutrophils were assessed by in vitro phagocytosis and killing of Staphylococcus aureus. The effect of molybdenum induced copper deficiency on bone marrow was monitored. The mean total leucocyte count was unaffected whereas a significant fall in neutrophil count coincided with the fall in hepatic copper level to $23.9{\pm}2.69$ ppm. Reduced blood neutrophil numbers was not accompanied by any change in the proportion of different neutrophil precursor cells in bone marrow. It was hypothesised that buffalo calves were more tolerant to dietary molybdenum excess than cattle. It was concluded that neutropenia in molybdenum induced copper deficiency occurred without any effect on their synthesis and maturation process. Bone marrow studies in healthy calves revealed higher percentage of neutrophilic myelocytes and metamyelocytes as compared to cattle.

Safety and Management of Toxicity Related to Aflibercept in Combination with Fluorouracil, Leucovorin and Irinotecan in Malaysian Patients with Metastatic Colorectal Cancer

  • Yusof, Mastura Md;Abdullah, Nik MA;Sharial, MSN Mohd;Zaatar, Adel
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.973-978
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    • 2016
  • Background: Between October 2012 and February 2015, 25 patients with metastatic colorectal cancer (mCRC) (mean age, $57.0{\pm}12.1years$) were granted access to aflibercept via the Aflibercept Named Patient Program at four centers. Materials and Methods: Here we reported the initial experience of aflibercept / FOLFIRI in combination. We evaluated treatment-related adverse events (AEs), progression-free survival (PFS) and overall survival (OS). Results: The majority of the patients experienced gastrointestinal toxicity (grade 1-2), with diarrhea (52%), mucositis (52%), and nausea/vomiting (20%) being largely observed. Neutropenia (16%) and febrile neutropenia (8%) were common grade 3-4 hematological events. Aflibercept-related toxicity was managed as per practice guidelines. No grade 5 event was reported. Median PFS was 6.12 months (95% CI, 4.80-7.20) and OS was 12 months (95% CI, 9.80-14.18). The partial response (PR), stable disease (SD), and progressive disease (PD) rates were 25% (95% CI: 23.4-27.0), 37.5% (95% CI: 31.6-43.3), and 37.5% (95% CI: 22.5-52.5), respectively. Conclusions: Aflibercept/FOLFIRI can be administered safely in a second line setting to Malaysian patients with mCRC, as the AEs experienced were generally reversible and manageable. The safety and efficacy outcomes were consistent with those observed in Western populations.

Increasing Antimicrobial Resistance Monitored in Surveillance Analysis of Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients

  • El-Mahallawy, Hadir A;Hassan, Safaa Shawky;El-Wakil, Mohamed;Moneer, Manar M;Shalaby, Lobna
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5691-5695
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    • 2015
  • Background: Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. Aim: To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients. Materials and Methods: Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. Results: A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006. Conclusions: The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.

The Story of Serratia Marcescens: Pathologic Risk Factors in Breast Implant Surgery

  • Yao, Caroline A.;Wang, Diana;Kulber, David A.
    • Archives of Plastic Surgery
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    • v.41 no.4
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    • pp.414-417
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    • 2014
  • Serratia marcescens (S. marcescens) emerged as an opportunist in the setting of immunodeficiency in the 1970s, when serious infections occurred in San Francisco hospitals after USA. Navy experiments had aerosolized the bacteria to study biologic warfare. We investigate the risks of S. marcescens in San Franciscans who undergo mastectomy with implant reconstruction. From 2007 to 2011, the senior author took breast capsule cultures for all patients at the time of tissue expander exchange/explant. Of the 142 women who had reconstruction, 23 had positive cultures. Only the two patients who were positive for S. marcescens developed clinical infections that required explantation. Both had postoperative chemotherapy with transient neutropenia, and both had close ties to San Francisco. Clinical signs of infection emerged for both patients months after initial surgery, despite having previously well healed incisions. Other patients were culture positive for Pseudomonas, Proteus, Enterococcus and MRSA and did not develop require explant. While the link between San Francisco and S. marcescens is controversial, a patient's geography is a simple screening tool when considering postoperative risks, especially in the immunocompromised. Closer monitoring for neutropenia during chemotherapy, and a lower threshold to administer S. marcescens targeted antibiotics may be warranted in these patients.

A Case of Neutropenia Induced by Short-Term Treatment of Vancomycin (반코마이신 단기간 투여로 유발된 호중구감소증 증례보고)

  • Kim, Su Hyun;Bang, Joon Seok;Kim, Kwang Joon;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.1
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    • pp.77-80
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    • 2013
  • 메치실린 저항성 황색 포도상구균(MRSA)에 감염된 환자에게 단기간 연속적으로 반코마이신을 투여했을 때 비정상적으로 호중구의 수치가 감소한 약인성 부작용 사례를 보고하고자 한다. 해당 여성 환자는 61세로서 MRSA 감염증을 판정받고 반코마이신 투여와 더불어 점차 백혈구(WBC)와 절대호중구수치(ANC)가 감소하였고, 제10일째에 이르러 호중구 감소증이 발생하여 ANC가 최저 430 $cells/mm^3$까지 낮아졌으나, 반코마이신의 투여를 중단하자 곧 정상수준으로 회복되었다. 본 사례는 Naranjo Probability Scale과 Korean Algorithm Score(Ver. 2.0)로 각각 평가하였을 때 반코마이신의 투여와 호중구감소증의 발현 사이에 모두 '가능한(probable)' 정도의 인과관계를 가진 것으로 평가되었다. 이는 통상적으로 20일 이상 연속투여를 할 때 임상적으로 관측되던 반코마이신-유래 호중구감소증이 단지 10일 정도의 단기간 투여만으로도 발생할 수 있다는 임상적 약물부작용의 사례로서, 향후 MRSA환자에게 반코마이신을 선택할 때에는 이와 같은 부작용을 고려하여 환자의 WBC와 ANC를 면밀히 관찰하면서 투여할 필요성이 있음을 시사한다.

An Appreciation of Functional Role of Macrophage in the Acute Lung Injury in the Neutropenic Rat. (호중구 감소증을 보이는 백서의 급성폐손상에서 대식세포의 기능적 역할)

  • Kim, Yong-Hoon;Ki, Sin-Young;Im, Keon-Il;Moon, Seung-Hyug;Cheong, Seung-Whan;Kim, Hyeon-Tae;Uh, Soo-Taek;Park, Choon-Sik;Jin, Byung-Won
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.379-390
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    • 1997
  • Background : It has long been suggested that neutrophils and their products are implicated as the central mediators of the acute lung injuries. Contrary to the dominant role of neutrophils in ARDS, many cases of ARDS has occurred in the setting of severe neutropenia without pulmonary neutrophil infiltration. Therefore it is certain that effector cell(s) other than neutrophil play an important role in the pathogenesis of ARDS. This experiment was performed to define the mechanism of ARDS in the setting of neutropenia, 1) by comparing the severity of endotoxin-induced lung injury, 2) by measurement of hydrogen peroxide production and cytokine concentration in the bronchoalveolar lavage cells and fluids obtained from different rats with and without cyclophosphamide-pretreatment. Method : The male Sprague-Dawleys were divided into the normal control (NC)-, endotoxin (ETX)-, and cyclophosphamide (CPA)-group in which neutropenia was induced by injecting cyclophosphamide intraperitoneally. Acute lung injury was evoked by injecting lipopolysaccharide (LPS) into a tail vein. The bronchoalveolar lavage (BAL) was performed at 3 and 6 hour after administration of LPS to measure the change of cell counts and concentrations of protein and cytokines, tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6). Hydrogen peroxide (HPO) production from BAL cells was measured at 6 hour after LPS administration by phenol red microassay with and without zymosan stimulation. Results : The results were as follows. A change of leukocyte counts in the peripheral blood after treatment with CPA : More than 95% of total leukocytes and neutrophils were reduced after CPA administration, resulting in severe neutropenia. A change of BAL cells : In the ETX-group, the number of total cells (p < 0.01) and of macrophage and neutrophil (p < 0.05) were increased at 3 and 6 hour after LPS administration compared to those of NC-group. In the CPA-group, the number of total leukocyte and macrophage were not changed after LPS administration, but neutrophil counts were significantly reduced and it took part in less than 0.1% of total BAL cells (p < 0.01 vs NC-group). BAL cells in this group were almost all macrophages (99.7%). A change of protein concentration in the BALF : In the ETX-group, protein concentration was increased at 3 hour and was more increased at 6 hour after LPS administration (p < 0.05 and < 0.01 vs NC-group, respectively). In the CPA-group, it was also significantly elevated at 3 hour after LPS administration (p < 0.05 vs NC-group), but the value was statistically not different from that of ETX-group. The value measured at 6 hour after LPS administration in the CPA-group became lower than that of ETX-group (p < 0.05), but showed still a higher value compared to that of NC-group (p < 0.05). A change of cytokine concentration in the BALF : TNF -alpha and IL-6 were elevated in the ETX - and CPA-group compared to those of NC-group at both time intervals. There was no statistical difference in the values of both cytokines between the ETX- and CPA-groups. Measurement of hydrogen peroxide production from BAL cells : There was no intergroup difference of HPO production from resting cells. HPO production after incubation with opsonized zymosan was significantly elevated in all groups. The percent increment of HPO production was highest in the ETX-group (89.0%, p < 0.0008 vs NC-group), and was 42.85 in the CPA-group (p = 0.003 vs NC-group ). Conclusion : Acute lung injury in the setting of neutropenia might be caused by functional activation of resident alveolar macrophages.

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Gemcitabine Plus Paclitaxel as Second-line Chemotherapy in Patients with Advanced Non-Small Cell Lung Cancer

  • Baykara, Meltem;Coskun, Ugur;Berk, Veli;Ozkan, Metin;Kaplan, Muhammet Ali;Benekli, Mustafa;Karaca, Halit;Inanc, Mevlude;Isikdogan, Abdurrahman;Sevinc, Alper;Elkiran, Emin Tamer;Demirci, Umut;Buyukberber, Suleyman
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5119-5124
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    • 2012
  • Purpose: The aim of this retrospective study was to determine response rates, progression-free survival (PFS), overall survival (OS) and toxicity of gemcitabine and paclitaxel combinations with advanced or metastatic non-small cell lung cancer patients (NSCLC) who have progressive disease after platinum-based first-line chemotherapy. Methods: We retrospectively evaluated the file records of patients treated with gemcitabine plus paclitaxel in advanced or metastatic NSCLC cases in a second-line setting. The chemotherapy schedule was as follows: gemcitabine $1500mg/m^2$ and paclitaxel 150 mg/m2 administered every two weeks. Results: Forty-eight patients (45 male, 3 female) were evaluated; stage IIIB/IV 6/42; PS0, 8.3%, PS1, 72.9%, PS2, 18.8%; median age, 56 years old (range 38-76). Six (12.5%) patients showed a partial response (PR), 13 (27.1%) stable disease (SD), and 27 (56.3%) progressive disease (PD). The median OS was 6.63 months (95% CI 4.0-9.2); the median PFS was 2.7 months (95% CI 1.8-3.6). Grade 3 and 4 hematologic toxicities, including neutropenia (n=4, 8.4%), and anemia (n=3, 6.3%) were encountered, but no grade 3 or 4 thrombocytopenia. One patient developed febrile neutropenia. There were no interruption for reasons of toxicity and no exitus related to therapy. Conclusion: The combination of two-weekly gemcitabine plus paclitaxel was an effective and well-tolerated second-line chemotherapy regimen for advanced or metastatic NSCLC patients previously treated with platinum-containing chemotherapy. Although the most common and dose limiting toxicities were neutropenia and neuropathy, this regimen was tolerated well by the patients.

Heteroscedasticity of Random Effects in Crossover Design

  • Ahn, Chul-H.
    • Proceedings of the Korean Statistical Society Conference
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    • 2002.11a
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    • pp.79-83
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    • 2002
  • A phase III clinical trial of a new drug for neutropenia induced by chemotherapy is presented and consider adding random effects in crossover design which was used in the clinical study. The diagnostics for its heteroscedasticity based on score statistic is derived for detecting homoscedasticity of errors in crossover design. A small simulation study is peformed to investigate the finite sample behaviour of the test statistic which is known to have an asymptotic chi-square distribution under the null hypothesis.

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Hemotological Change of Canine Babesiasis (개 바베시아증 혈액상변화)

  • 신종욱;김덕유
    • Journal of Veterinary Clinics
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    • v.17 no.2
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    • pp.346-348
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    • 2000
  • In previous studies, high fever, inappentence, increased respiratory rate, muscle tremors, anemia, jaundice, loss of weight hemoglobinenuria and hemoglobinuria were found in dogs infected intraerythrocytic protzoan parasites of the gennus Babesia. These changes were mainly caused by the intravascular hemolysis. In this study, a Pit Bull Terrier, which was infected by babesia, was investigated clinical signs and patterms of blood. The findings from this study indicated that dog with severs clinical signs shown erythropenia, lymphocytophilia, neutropenia, thrombocytopenia and eosinpenia. Furthermore, it presenter low level of hemglobin and hematocrit. However MCV, MCH and MCHC did not decreased as compare to normal dogs.

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Immunostimulatory Effect of Ginkgolides Enhances Resistance of Neutropenic Mice against Hematogenously Disseminated Candidiasis

  • Lee, Jue-Hee;Han, Yong-Moon
    • Proceedings of the PSK Conference
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    • 2003.10b
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    • pp.137.1-137.1
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    • 2003
  • We investigated immunoactivity of ginkgolides (GLS), the primary active constituent of Ginkgo biloba leaves, against disseminated candidiasis due to Candida albicans. This fungus is a polymorphic opportunistic pathogen. BALB/c mice were induced neutropenia by intraperitoneal (i.p.) injection of cyclophosphamide (CP) 24 hours before an i.p administration of GLS (2 mg/mouse) to the mice. Control mice received diluent (Dulbecco's phosphate saline solution; DPBS) instead of GLS. (omitted)

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