ABSTRACT
Data on herpes simplex virus (HSV) polymorphism as well as acyclovir (ACV) and foscarnet (FOS) resistance mutations are not exhaustive and may hinder accurate diagnosis by next-generation sequencing (NGS). Here, we report novel UL23 and UL30 substitutions for HSV1 and HSV2 identified in immunocompromised patients treated for hematological malignancies during the last 6 years of HSV resistance surveillance at the University Hospital of Lyon. For HSV1, 35 novel UL23 substitutions and 52 novel UL30 substitutions were identified. For HSV2, 2 novel UL23 substitutions and 12 novel UL30 substitutions were identified. These results allow to complete the database of HSV1 and HSV2 substitutions, related either to polymorphism or to ACV and FOS resistance.
Subject(s)
Herpes Simplex , Herpesvirus 1, Human , Humans , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , Herpes Simplex/drug therapy , Herpesvirus 1, Human/genetics , Viral Proteins/genetics , Drug Resistance, Viral/genetics , Acyclovir/pharmacology , Acyclovir/therapeutic use , Foscarnet/therapeutic useSubject(s)
Leukemia, Myeloid, Acute/chemically induced , Leukemia, Promyelocytic, Acute/drug therapy , Myelodysplastic Syndromes/chemically induced , Adult , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cytarabine/administration & dosage , Female , Humans , Idarubicin/administration & dosage , Leukemia, Myeloid, Acute/pathology , Leukemia, Promyelocytic, Acute/pathology , Male , Middle Aged , Myelodysplastic Syndromes/pathology , Tretinoin/administration & dosageABSTRACT
Invasive aspergillosis (IA) during induction chemotherapy of acute myeloid leukemia (AML) could worsen the prognosis. Our objective was to study how the development of IA during AML interferes with the therapeutic strategy and to evaluate its impact on the short- and long-term survival. Newly diagnosed AML patients between the years 2004 and 2007 were retrospectively analyzed. The outcome was death of the patient. A Cox proportional hazards model with the diagnosis of IA and post-induction response evaluation as the main exposure was fitted. Overall, 262 patients were analyzed and 58 IA were observed. The 2-year survival of patients having had remission of AML was 54% and, for patients with failure of chemotherapy, it was 5% (p < 0.001). The 2-year survival of patients having had IA was 14%, and without IA, it was 32% (p = 0.01). Multivariate analysis showed that IA was associated with a higher risk of death in case of remission compared to no IA (hazard ratio [HR] = 1.66 [1.05-2.65], p = 0.031) and also in case of failure (HR = 6.43, p < 0.001). IA was associated with an increased risk of death for patients if they were either in remission or in failure after induction chemotherapy.
Subject(s)
Aspergillosis/epidemiology , Aspergillosis/mortality , Fungemia/epidemiology , Fungemia/mortality , Leukemia, Myeloid, Acute/complications , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/administration & dosage , Female , Humans , Immunocompromised Host , Leukemia, Myeloid, Acute/drug therapy , Male , Middle Aged , Retrospective Studies , Risk Factors , Survival AnalysisABSTRACT
Acquired anti-factor V (FV) antibodies are uncommon and the majority of reported cases are idiopathic or associated with pregnancy, malignancy, autoimmune diseases or the use of bovine thrombin preparations. Clinical presentation is highly variable, ranging from asymptomatic to life-threatening bleeding and the optimal treatment is not clearly established. We here report two patients with different clinical presentations. The first patient presented with an acute severe rectal bleeding related to acquired FV deficiency and recurrent colon cancer while the second patient was asymptomatic with a FV inhibitor detected during a routine blood testing. We discuss treatment modalities that are not consensual.
