scholarly journals Voriconazole-Resistant Penicillium oxalicum: An Emerging Pathogen in Immunocompromised Hosts

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Anuradha Chowdhary ◽  
Shallu Kathuria ◽  
Kshitij Agarwal ◽  
Neelam Sachdeva ◽  
Pradeep K. Singh ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Penicillium Oxalicum ◽  
Chronic Obstructive ◽  
Emerging Pathogen ◽  
Penicillium Species ◽  
Obstructive Pulmonary Disease ◽  
Invasive Mycosis ◽  
Invasive Mycoses ◽  
Immunocompromised Hosts ◽  
Acute Myeloid

Abstract Penicillium species are rarely reported agents of infections in immunocompromised patients. We report 3 cases of invasive mycosis caused by voriconazole-resistant Penicillium oxalicum in patients with acute myeloid leukemia, diabetes mellitus, and chronic obstructive pulmonary disease, while on voriconazole therapy. Penicillium oxalicum has not been previously recognized as a cause of invasive mycoses.

scholarly journals Prognosis of Patients with Acute Myeloid Leukemia Regarding the Presence FLT3 Gene Mutation – a Case Report

2017 ◽  
Vol 2 (s4) ◽  
pp. 42-44
Author(s):  
Árpád Bzduch ◽  
István Benedek ◽  
Szilárd Bíró ◽  
Johanna Sándor-Kéri ◽  
Erzsébet Lázár ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Tyrosine Kinase ◽  
Myeloid Leukemia ◽  
Kinase Activity ◽  
Bone Marrow Cells ◽  
Physical Exertion ◽  
Chronic Obstructive ◽  
Tyrosine Kinase Activity ◽  
Pharmacological Agents ◽  
Acute Myeloid

AbstractAcute myeloid leukemia (AML) is a cancerous disease affecting the myeloid line of the bone marrow cells. FLT3, also known as CD135, is a proto-oncogene, which, if mutated, leads to different types of cancer. The protein it encodes presents tyrosine-kinase activity, and its intratandem mutation, FLT3-ITD, leads to uncontrolled proliferation of myeloblasts and worse outcomes in AML patients. There are currently several pharmacological agents that can inhibit the effect of either the proteins with tyrosine-kinase activity or the mutated FLT3 gene. We present the case of a 68-year-old patient, smoker, with a history of arterial hypertension, chronic obstructive pulmonary disease, presenting with headache unresponsive to antalgics, dyspnea after physical exertion, and epistaxis, with onset 2 months prior to his presentation. The patient was diagnosed with AML with positive FTL3 mutation for which conventional induction therapy was initiated. Within the next days, the patient presented several complications related to the disease itself or caused by the treatment, which eventually led to his death.

scholarly journals Comparative clinical and economic analysis of pozaconazol (Noxafil) for invasive mycoses (IM) prevention in patients with severe neutropenia during treatment of acute myeloid leukemia or myelodysplastic syndrome

2019 ◽  
Vol 14 (1) ◽  
pp. 49-59
Author(s):  
I. S. Krysanov ◽  
N. N. Klimko ◽  
V. Yu. Ermakova ◽  
V. S. Krysanova
Keyword(s):  
Sensitivity Analysis ◽  
Acute Myeloid Leukemia ◽  
Cost Effectiveness ◽  
Economic Analysis ◽  
Myelodysplastic Syndrome ◽  
Myeloid Leukemia ◽  
Budget Impact ◽  
Severe Neutropenia ◽  
Invasive Mycoses ◽  
Acute Myeloid

Objective:a comparative clinical and economic analysis of posaconazole (Noxafil) for invasive mycoses (IM) prevention in patients with severe neutropenia during treatment of acute myeloid leukemia or myelodysplastic syndrome in Russia.Materials and methods.A model was constructed that takes into account the use of various mediactions: posaconazole, voriconazole and fluconazole. Cost estimation for IM prevention was carried out considering the direct medical costs of IM prevention, IM therapy, hospital stay, therapeutic and diagnostic procedures and monitoring in case of IM. “Cost–effectiveness” and “budget impact” analyzes were performed.Results.Based on literature data, high efficacy and safety of posaconazole for IM prevention in patients with severe neutropenia during treatment of acute myeloid leukemia or myelodysplastic syndrome was shown. Cost analysis of drugs showed the lowest total costs for IM prevention with posaconazole – 185,745.49 rubles, followed by fluconazole – 275,360.26 rubles, and voriconazole – 299,792.76 rubles. At the same time, in the structure of total costs, for posaconazole and voriconazole, the cost of IM prevention prevailed – 155,017.17 rubles and 156,393.92 rubles, respectively, whereas for fluconazole – the costs of IM treatment – 168,390.45 rubles. This is due to the significantly higher incidence of IM cases in fluconazole group compared with posaconazole and voriconazole. The use of posaconazole also showed the best ratio of cost–effectiveness for one prevented case of infection and for one extended year of the patient’s life (191,490.20 rubles and 34,980.32, respectively). Due to lowest costs and best efficiency of posaconazole, the incremental cost– effectiveness ratio (ICER) was not calculated. Thus, the use of posaconazole for IM prevention in acute myeloid leukemia patients can reduce the overall cost per patient by 114,047.27 rubles compared with voriconazole and by 89,614.76 rubles compared with fluconazole. The sensitivity analysis for cost–effectiveness results demonstrated the stability of IM prevention model in acute myeloid leukemia patients to changes in the initial posaconazole price upwards to +61 %. The model has the highest sensitivity to IM incidence with unsuccessful prevention. “Budget impact” analysis of IM prevention in acute myeloid leukemia patients older than 13 years in Russia showed that an increase in the posaconazole proportion from 25 to 50 % with a decrease of voriconazole proportion from 25 to 15 % and fluconazole proportion from 50 to 35 % in government procurement will reduce budget costs by 48.1 million rubles. The sensitivity analysis for “budget impact” results showed the greatest sensitivity to changes in the patient number and to increase of posaconazole proportion in procurement. Results were less sensitive to an increase of voriconazole and fluconazole proportion.Conclusion.The results of the study showed that the use of posaconazole for the prevention of invasive mycoses in patients with severe neutropenia during treatment of acute myeloid leukemia and myelodysplastic syndrome is clinically effective and economically justified within the system of state preferential drug provision in the Russia.

scholarly journals Isavuconazole therapy of disseminated and encephalic Saprochaete capitata infection in an acute myeloid leukemia patient treated with midostaurin.

2020 ◽  
Vol 12 (1) ◽  
pp. e2020026 ◽  
Author(s):  
Salvatore Perrone ◽  
Chiara Lisi ◽  
Elettra Ortu La Barbera ◽  
Cristina Luise ◽  
Miriam Lichtner ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Case Report ◽  
Myeloid Leukemia ◽  
Liposomal Amphotericin ◽  
Acute Myeloid Leukemia Patient ◽  
Leukemia Patient ◽  
Neutropenic Patients ◽  
Cerebral Infection ◽  
Immunocompromised Hosts ◽  
Acute Myeloid

BACKGROUND Saprochaete capitata is a rare and emerging opportunistic fungus, involving immunocompromised hosts, in particular neutropenic patients after chemotherapy. CASE REPORT We report a case of disseminated and cerebral infection by Saprochaete capitata, in a 68-year-old woman affected by acute myeloid leukemia that was successfully managed with liposomal amphotericin B and isavuconazole. CONCLUSION this case illustrates the feasibility of isavuconazole therapy in the treatment of a S.capitata infection when co-administered with midostaurin.

scholarly journals THE EFFICACY OF POSACONAZOLE FOR PROPHYLAXIS OF INVASIVE MYCOSES IN PATIENTS WITH ACUTE MYELOID LEUKEMIA

2017 ◽  
pp. 118-124
Author(s):  
G. A. Klyasova ◽  
V. A. Okhmat ◽  
E. N. Parovichnikova ◽  
E. O. Gribanova ◽  
V. V. Troitskaya ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Median Duration ◽  
Myeloid Leukemia ◽  
De Novo ◽  
Invasive Pulmonary Aspergillosis ◽  
Chemotherapy Cycle ◽  
Pulmonary Aspergillosis ◽  
Invasive Mycoses ◽  
De Novo Aml ◽  
Acute Myeloid

Efficacy of posaconazole for prophylaxis was evaluated in 77 chemotherapy cycles in 59 patients with acute myeloid leukemia (AML) aged 39 (17–62) years from 2012  till 2017. Posaconazole was given in oral suspension 200 mg three times a day after meal during chemotherapy cycle or on 1st  day after the cycle. Administration of posaconazole predominated in patients with de novo AML (84.5%) on 1st induction cycles (66.3%). Neutropenia was present in all patients with median duration of 22 days. Median duration of prophylaxis was 21  (2–57)  days. Posaconazole prophylaxis was interrupted in 28  (36.4%) of 77 cases, mainly due to diarrhea (28.6%). In 17 (61%) of 28 cases prophylaxis was resumed within a median of 3 days. In 72 (93.5%) of cases duration of posaconazole prophylaxis was ≥ 7 days, in 5 (6.5%) cases < 7 days. Efficacy of prophylaxis was evaluated in cases of posaconazole duration ≥ 7 days. Invasive pulmonary aspergillosis (probable) was in 2 (2.7%) of 72 cases. Administration of posaconazole with duration ≥ 7 days was in 46 cases on chemotherapy cycle, in 26 cases – on first day after the cycle. Patients using Posaconazole after a course of chemotherapy in comparison with patients receiving the drug in the first days of the course had significantly less interruptions of prophylaxis (11,5% vs 41,3%, p=0.009) and a reduction in duration of Posaconazole using (19 days vs 27 days, p=0.007).One case of invasive aspergillosis was registered in each group.We confirmed the  efficacy of posaconazole  for prophylaxis of invasive mycoses  in patients  with AML. Administration of posaconazole prophylaxis on first day after the end of chemotherapy cycle results in saving of drug by reducing duration of posaconazole using by 8 days and does not increase the incidence of invasive mycoses.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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