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1.
Transpl Infect Dis ; : e14345, 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39012614

RESUMO

INTRODUCTION: This study explored the efficacy of repeat blood cultures in bacteremic acute myeloid leukemia (AML) patients following allogeneic hematopoietic stem cell transplantation (HSCT). METHODS: This was a retrospective study of AML patients who experienced febrile neutropenia (FN) and bacteremia following HSCT at the Taussig Cancer Center from January 1, 2019, to December 31, 2022. The primary endpoint was the rate of positive repeat blood cultures following initial positive blood culture. RESULTS: Fifty patients were included in the study. There were 50 occurrences of FN with positive initial blood cultures that were diagnosed following HSCT. Fifty initial sets of blood cultures and 96 sets of repeat blood cultures were drawn between the 50 occurrences of FN. Twelve of 96 (12.5%) repeat blood culture sets were positive for a pathogen, which occurred over nine of 50 (18.0%) episodes of FN. Three of 96 (3.2%) repeat blood culture sets grew a pathogen that differed from the pathogen that grew in the preceding positive blood culture. CONCLUSION: Among bacteremic AML patients in the post-HSCT period, the yield of repeat blood cultures for detecting previously detected and new pathogens was low.

2.
Cleve Clin J Med ; 90(8): 499-508, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-37527880

RESUMO

Survivors of allogeneic hematopoietic cell transplant (HCT) face the risk of many serious complications in the long term, which primary care physicians play an integral role in recognizing and treating. In this review, the authors summarize the most common complications that primary care physicians see after HCT recipients return to their care: chronic graft-vs-host disease; cardiovascular, metabolic, endocrine, rheumatologic, orthopedic, infectious, neurologic, and cognitive complications; secondary malignancies; psychiatric disorders; and impairments in quality of life and sexual health. Also discussed are health maintenance and screening recommendations for this patient population.


Assuntos
Síndrome de Bronquiolite Obliterante , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Médicos de Atenção Primária , Humanos , Doença Enxerto-Hospedeiro/diagnóstico , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/prevenção & controle , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Qualidade de Vida
3.
Hematol Oncol ; 41(4): 718-724, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37231908

RESUMO

This study explored the efficacy of intravenous immunoglobulin (IVIG) prophylaxis in reducing infection-related hospitalizations (IRHs) in MM patients. This was a retrospective study of MM patients who received IVIG at Taussig Cancer Center between July 2009 and July 2021. The primary endpoint was rate of IRHs per patient-year on-IVIG versus off-IVIG. 108 patients were included. There was a significant difference in the primary endpoint of rate of IRHs per patient-year on-IVIG versus off-IVIG in the overall study population (0.81 vs. 1.08; Mean Difference [MD], -0.27; 95% Confidence Interval [CI], -0.57 to 0.03; p value [P] = 0.04). The subgroup of patients with a 1-year period of continuous IVIG (49, 45.3%), the subgroup with standard-risk cytogenetics (54, 50.0%) and the subgroup with 2 or more IRHs (67, 62.0%) all showed a significant reduction in IRHs while on-IVIG versus off-IVIG (0.48 vs. 0.78; MD, -0.30; 95% CI, -0.59 to 0.002; p = 0.03) and (0.65 vs. 1.01; MD, -0.36; 95% CI, -0.71 to -0.01; p = 0.02) and (1.04 vs. 1.43; MD, -0.39; 95% CI, -0.82 to 0.05; p = 0.04) respectively. IVIG showed significant benefit in reducing IRHs in the overall population and in multiple subgroups.


Assuntos
Imunoglobulinas Intravenosas , Mieloma Múltiplo , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico , Estudos Retrospectivos , Hospitalização
4.
Clin Lymphoma Myeloma Leuk ; 22(10): 726-734, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35750574

RESUMO

It has been proposed that direct measurement of adiposity has a greater accuracy as a prognostic factor in various malignancies than anthropometric measures such as BMI. We evaluated the association of visceral and subcutaneous adiposity with outcomes in patients with hematological malignancies with a systematic review and meta-analysis. This systematic review included patients with hematological malignancies who had the analysis of overall mortality and progression-free survival according to their adiposity status. We identified 3137 articles, of which we included seven studies. Patients with visceral low visceral adiposity had 2 times greater mortality risk (HR 2.02, P = .0004) and 80% higher risk of death or disease progression (HR 2.98, P = 0.0002), than patients with normal visceral obesity. Patients classified with subcutaneous adipopenia had almost 3 times greater mortality risk. In conclusion, hematological malignancy patients having low adiposity (subcutaneous or visceral) have worse outcomes.


Assuntos
Adiposidade , Neoplasias Hematológicas , Índice de Massa Corporal , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/patologia , Humanos , Gordura Intra-Abdominal/patologia , Obesidade/complicações , Prognóstico
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