scholarly journals Properdin Levels in Individuals with Chemotherapy-Induced Neutropenia

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Artsiom Tsyrkunou ◽  
Sarika Agarwal ◽  
Bibek Koirala ◽  
Robert W. Finberg ◽  
Rajneesh Nath ◽  
...  
Keyword(s):  
Neutrophil Count ◽  
Hematological Malignancies ◽  
Alternative Pathway ◽  
Pairwise Comparison ◽  
Serum Concentrations ◽  
Risk Of Infection ◽  
Hematopoietic Stem ◽  
Increased Risk ◽  
Neutropenic Patients ◽  
The Relationship

Abstract Background Neutrophils produce and carry key components of the alternative pathway (AP) of complement, including properdin (P). The effect of chemotherapy-induced absolute neutropenia on circulating P levels and AP function has not been previously established. Methods We prospectively measured free P levels in serum from 27 individuals expected to develop neutropenia after administration of chemotherapy for hematological malignancies in preparation for hematopoietic stem cell transplantation and here describe the relationship between serum P levels and the neutrophil count over time. Results When the absolute neutrophil count (ANC) was >500 cells/mm3 pre-chemotherapy, P levels were significantly higher than P levels associated with an ANC ≤500 cells/mm3 (median values 8392 ng/mL and 6355 ng/mL, respectively; P = .001). Pairwise comparison between pre-chemotherapy P levels and P levels at initial or last documented neutropenia before recovery showed a significant decline (P < .0001). No correlation was observed between P levels during neutropenia and after recovery of neutropenia in 20 subjects for which postneutropenia samples were obtained. A small but significant (P = .02) decrease in AP hemolytic activity was noted between baseline (preneutropenia) and samples obtained at the onset of neutropenia, but only with low (6.25%) and not higher (12.5 or 25%) serum concentrations. Conclusions A decline in P levels and AP activity could contribute to the increased risk of infection in neutropenic patients and warrants further study.

scholarly journals Risk of infection associated with targeted therapies for solid organ and hematological malignancies

2021 ◽  
Vol 8 ◽  
pp. 204993612198954
Author(s):  
Isabel Ruiz-Camps ◽  
Juan Aguilar-Company
Keyword(s):  
Hematological Malignancies ◽  
Opportunistic Infections ◽  
Respiratory Infections ◽  
Fungal Infections ◽  
Checkpoint Inhibitors ◽  
Janus Kinase ◽  
Prolonged Treatment ◽  
Solid Organ ◽  
Risk Of Infection ◽  
Increased Risk

Higher risks of infection are associated with some targeted drugs used to treat solid organ and hematological malignancies, and an individual patient’s risk of infection is strongly influenced by underlying diseases and concomitant or prior treatments. This review focuses on risk levels and specific suggestions for management, analyzing groups of agents associated with a significant effect on the risk of infection. Due to limited clinical experience and ongoing advances in these therapies, recommendations may be revised in the near future. Bruton tyrosine kinase (BTK) inhibitors are associated with a higher rate of infections, including invasive fungal infection, especially in the first months of treatment and in patients with advanced, pretreated disease. Phosphatidylinositol 3-kinase (PI3K) inhibitors are associated with an increased risk of Pneumocystis pneumonia and cytomegalovirus (CMV) reactivation. Venetoclax is associated with cytopenias, respiratory infections, and fever and neutropenia. Janus kinase (JAK) inhibitors may predispose patients to opportunistic and fungal infections; need for prophylaxis should be assessed on an individual basis. Mammalian target of rapamycin (mTOR) inhibitors have been linked to a higher risk of general and opportunistic infections. Breakpoint cluster region-Abelson (BCR-ABL) inhibitors are associated with neutropenia, especially over the first months of treatment. Anti-CD20 agents may cause defects in the adaptative immune response, hypogammaglobulinemia, neutropenia, and hepatitis B reactivation. Alemtuzumab is associated with profound and long-lasting immunosuppression; screening is recommended for latent infections and prevention strategies against CMV, herpesvirus, and Pneumocystis infections. Checkpoint inhibitors (CIs) may cause immune-related adverse events for which prolonged treatment with corticosteroids is needed: prophylaxis against Pneumocystis is recommended.

Abstract WP200: Post-operative Infection Does not Increase Risk of Post-operative Stroke: Analysis From a Nationwide Quality Initiative Program

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Benjamin R Kummer ◽  
Rebecca Hazan ◽  
Hooman Kamel ◽  
Alexander E Merkler ◽  
Joshua Z Willey ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Odds Ratio ◽  
Postoperative Infection ◽  
Adjusted Odds Ratio ◽  
Risk Of Infection ◽  
Postoperative Stroke ◽  
Increased Risk ◽  
Increase Risk ◽  
Initiative Program ◽  
The Relationship

Introduction: Infection has been described as a trigger for acute ischemic stroke, but the relationship between postoperative infection and the risk of postoperative stroke is unclear. We investigated the association between postoperative infection and stroke using the American College of Surgeons National Surgical Quality Initiative Program (NSQIP) database. Hypothesis: Postoperative infection is associated with an increased risk of postoperative stroke. Methods: We used the NSQIP database to identify all patients who underwent surgery between the years of 2000 and 2010 and developed a postoperative stroke within 30 days of surgery. The group was further stratified according to the presence of infection preceding stroke. Using a logistic regression model adjusted for age, race, sex, medical comorbidities, surgical type, and dichotomized functional status, we compared the risk of stroke in patients with and without preceding infections, and investigated the risk of infection following stroke. Results: 729,886 surgical patients were identified, of whom 2,703 (0.3%) developed postoperative stroke. 848 (0.12%) patients developed both postoperative stroke and infection. Among patients who had postoperative stroke, 100 (3.7%) had developed an infection prior to developing a stroke. Patients with infection prior to stroke had a lower risk of stroke than patients who did not develop infection prior to stroke (adjusted odds ratio [OR] 0.25, 95%CI 0.20-0.32). 748 patients (0.1%) developed an infection after having a postoperative stroke. These patients had a higher risk of infection (incidence rate ratio 2.76, 95%CI 2.57-2.97) and a higher odds of infection (adjusted odds ratio [OR] 3.47, 95%CI 3.18-3.78) than patients who did not have a stroke. Conclusions: We found that the presence of a preceding infection was associated with a low risk of postoperative stroke in a large surgical inpatient sample. Although the total number of strokes may have been under-reported, these results conflict with other studies that report that infection is a trigger for ischemic stroke. Further analyses using more granular data are needed to investigate the relationship between postoperative infection and the risk of postoperative stroke.

scholarly journals ANTIFUNGAL PROPHYLAXIS IN IMMUNOCOMPROMISED PATIENTS

2016 ◽  
Vol 8 ◽  
pp. e2016040 ◽  
Author(s):  
Lourdes Vazquez
Keyword(s):  
Gold Standard ◽  
Concomitant Medication ◽  
Hematological Malignancies ◽  
Fungal Infections ◽  
Antifungal Prophylaxis ◽  
Antifungal Drugs ◽  
Risk Of Infection ◽  
Scientific Societies ◽  
Hematopoietic Stem ◽  
Poor Efficacy

Invasive fungal infections (IFIs) represent significant complications in patients with hematological malignancies. Chemoprevention of IFIs may be important in this setting, but most antifungal drugs have demonstrated poor efficacy, particularly in the prevention of invasive aspergillosis. Antifungal prophylaxis in hematological patients is currently regarded as the gold standard in situations with a high risk of infection, such as acute leukemia, myelodysplastic syndromes, and autologous or allogeneic hematopoietic stem cell transplantation. Over the years, various scientific societies have established a series of recommendations for antifungal prophylaxis based on prospective studies performed with different drugs. However, the prescription of each agent must be personalized, adapting its administration to the characteristics of individual patients and taking into account possible interactions with concomitant medication.

scholarly journals Aging, hematopoiesis, and the myelodysplastic syndromes

2017 ◽  
Vol 1 (26) ◽  
pp. 2572-2578 ◽  
Author(s):  
Stephen S. Chung ◽  
Christopher Y. Park
Keyword(s):  
Myelodysplastic Syndromes ◽  
Bone Marrow Failure ◽  
Hematologic Malignancies ◽  
Relative Increase ◽  
Extrinsic Factors ◽  
Hematopoietic Stem ◽  
Clonal Hematopoiesis ◽  
Increased Risk ◽  
The Many ◽  
The Relationship

Abstract The aging hematopoietic system undergoes numerous changes, including reduced production of red blood cells and lymphocytes as well as a relative increase in the production of myeloid cells. Emerging evidence indicates that many of these changes are due to selection pressures from cell-intrinsic and cell-extrinsic factors that result in clonal shifts in the hematopoietic stem cell (HSC) pool, resulting in predominant HSC clones that exhibit the functional characteristics associated with HSC aging. Given the recent descriptions of clonal hematopoiesis in aged populations, the increased risk of developing hematologic malignancies in individuals with clonal hematopoiesis, and the many similarities in hematopoietic aging and acquired bone marrow failure (BMF) syndromes, such as myelodysplastic syndromes (MDS), this raises significant questions regarding the relationship between aging hematopoiesis and MDS, including the factors that regulate HSC aging, whether clonal hematopoiesis is required for the development of MDS, and even whether BMF is an inevitable consequence of aging. In this article, we will review our current understanding of these processes and the potential intersections among them.

Hospital Water Supply as a Source of Disseminated Mycobacterium fortuitum Infection in a Leukemia Patient

1999 ◽  
Vol 20 (05) ◽  
pp. 343-345 ◽  
Author(s):  
Juha Kauppinen ◽  
Tapio Nousiainen ◽  
Esa Jantunen ◽  
Rauni Mattila ◽  
Marja-Leena Katila
Keyword(s):  
Water Supply ◽  
Molecular Typing ◽  
Water System ◽  
Mycobacterium Fortuitum ◽  
Risk Of Infection ◽  
Environmental Isolates ◽  
Disseminated Infection ◽  
Leukemia Patient ◽  
Increased Risk ◽  
Neutropenic Patients

AbstractNosocomial acquisition ofMycobacterium fortuitumled to a disseminated infection in a leukemia patient. A linkage to shower-head water was supported by molecular typing of clinical and environmental isolates. Contamination of the hospital water system with microbes that are relatively resistant to common sanitation processes poses an increased risk of infection to neutropenic patients.

scholarly journals Philadelphia-Negative Chronic Myeloproliferative Neoplasms during the COVID-19 Pandemic: Challenges and Future Scenarios

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4750
Author(s):  
Francesca Palandri ◽  
Massimo Breccia ◽  
Valerio De Stefano ◽  
Francesco Passamonti
Keyword(s):  
Hematological Malignancies ◽  
Myeloproliferative Neoplasms ◽  
Published Data ◽  
Future Scenarios ◽  
Risk Of Infection ◽  
Immunosuppressive Activity ◽  
Chronic Myeloproliferative Neoplasms ◽  
Increased Risk ◽  
Abrupt Discontinuation ◽  
Case Basis

An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) started in December 2019 in China and then become pandemic in February 2020. Several publications investigated the possible increased rate of COVID-19 infection in hematological malignancies. Based on the published data, strategies for the management of chronic Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) are provided. The risk of severe COVID-19 seems high in MPN, particularly in patients with essential thrombocythemia, but not negligible in myelofibrosis. MPN patients are at high risk of both thrombotic and hemorrhagic complications and this must be accounted in the case of COVID-19 deciding on a case-by-case basis. There are currently no data to suggest that hydroxyurea or interferon may influence the risk or severity of COVID-19 infection. Conversely, while the immunosuppressive activity of ruxolitinib might pose increased risk of infection, its abrupt discontinuation during COVID-19 syndrome is associated with worse outcome. All MPN patients should receive vaccine against COVID-19; reassuring data are available on efficacy of mRNA vaccines in MPNs.

scholarly journals Clonal hematopoiesis is associated with risk of severe Covid-19

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kelly L. Bolton ◽  
Youngil Koh ◽  
Michael B. Foote ◽  
Hogune Im ◽  
Justin Jee ◽  
...  
Keyword(s):  
Driver Mutations ◽  
Tumor Patients ◽  
Hematopoietic Stem ◽  
Cancer Driver ◽  
Clonal Hematopoiesis ◽  
Increased Risk ◽  
Stem And Progenitor Cells ◽  
Severe Infections ◽  
The Relationship ◽  
Immunologic Profile

AbstractAcquired somatic mutations in hematopoietic stem and progenitor cells (clonal hematopoiesis or CH) are associated with advanced age, increased risk of cardiovascular and malignant diseases, and decreased overall survival. These adverse sequelae may be mediated by altered inflammatory profiles observed in patients with CH. A pro-inflammatory immunologic profile is also associated with worse outcomes of certain infections, including SARS-CoV-2 and its associated disease Covid-19. Whether CH predisposes to severe Covid-19 or other infections is unknown. Among 525 individuals with Covid-19 from Memorial Sloan Kettering (MSK) and the Korean Clonal Hematopoiesis (KoCH) consortia, we show that CH is associated with severe Covid-19 outcomes (OR = 1.85, 95%=1.15–2.99, p = 0.01), in particular CH characterized by non-cancer driver mutations (OR = 2.01, 95% CI = 1.15–3.50, p = 0.01). We further explore the relationship between CH and risk of other infections in 14,211 solid tumor patients at MSK. CH is significantly associated with risk of Clostridium Difficile (HR = 2.01, 95% CI: 1.22–3.30, p = 6×10−3) and Streptococcus/Enterococcus infections (HR = 1.56, 95% CI = 1.15–2.13, p = 5×10−3). These findings suggest a relationship between CH and risk of severe infections that warrants further investigation.

scholarly journals Vaccination against SARS-COV‑2 in oncology

2021 ◽  
Vol 16 (2) ◽  
pp. 70-80
Author(s):  
A. A. Polyakov ◽  
V. V. Lunin ◽  
F. M. Abbaysbeyli ◽  
O. L. Timofeeva ◽  
V. B. Larionova ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Information Search ◽  
World Literature ◽  
Hematological Malignancies ◽  
Web Of Science ◽  
Careful Monitoring ◽  
Hematopoietic Stem ◽  
Patients With Cancer ◽  
Increased Risk ◽  
The Moment

The objective of the study a detailed, systematic review of the world literature data, which includes all aspects of recommendations for vaccination against SARS-COV‑2 in cancer patients.Materials and methods. Information search was carried out in PubMed, MedLine, Scopus, Web of Science, RSCI.The work included data from literature and information sources that were published before February 2021.Results. The data of retrospective and prospective clinical studies are analyzed. This paper reflects considerations and recommendations for the vaccination of cancer patients by Russian and foreign specialists in the context of COVID‑19 pandemic. The review presents current recommendations for vaccination against SARS-COV‑2 in patients with solid tumors, hematological malignancies, recipients of hematopoietic stem cells and cell therapy.Conclusion. To date, groups at increased risk of infection with the new coronavirus have been identified. These groups include patients with cancer. The presence of tumor does not allow a delay in start of therapy, and requires careful monitoring and observation. In this regard, despite the pandemic, the treatment of cancer patients must be continued regardless of the circumstances. Cancer patients should not be deprived of the opportunity to be vaccinated against SARS-COV‑2. Every patient should be decided individually. At the moment, there are no officially approved recommendations for vaccination against SARS-COV‑2 for cancer patients. Before the creation and approval of final recommendations for cancer patients, it is necessary to focus on compliance with sanitary and anti-epidemic measures and the prevention of COVID‑19 infection. The global cancer community continues to actively develop recommendations for the optimal vaccination against SARS-COV‑2 in cancer patients.The most relevant ones are outlined in this article.

scholarly journals Aging, hematopoiesis, and the myelodysplastic syndromes

Hematology ◽  
2017 ◽  
Vol 2017 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Stephen S. Chung ◽  
Christopher Y. Park
Keyword(s):  
Myelodysplastic Syndromes ◽  
Bone Marrow Failure ◽  
Hematologic Malignancies ◽  
Relative Increase ◽  
Extrinsic Factors ◽  
Hematopoietic Stem ◽  
Clonal Hematopoiesis ◽  
Increased Risk ◽  
The Many ◽  
The Relationship

Abstract The aging hematopoietic system undergoes numerous changes, including reduced production of red blood cells and lymphocytes as well as a relative increase in the production of myeloid cells. Emerging evidence indicates that many of these changes are due to selection pressures from cell-intrinsic and cell-extrinsic factors that result in clonal shifts in the hematopoietic stem cell (HSC) pool, resulting in predominant HSC clones that exhibit the functional characteristics associated with HSC aging. Given the recent descriptions of clonal hematopoiesis in aged populations, the increased risk of developing hematologic malignancies in individuals with clonal hematopoiesis, and the many similarities in hematopoietic aging and acquired bone marrow failure (BMF) syndromes, such as myelodysplastic syndromes (MDS), this raises significant questions regarding the relationship between aging hematopoiesis and MDS, including the factors that regulate HSC aging, whether clonal hematopoiesis is required for the development of MDS, and even whether BMF is an inevitable consequence of aging. In this article, we will review our current understanding of these processes and the potential intersections among them.

scholarly journals Clonal hematopoiesis is associated with risk of severe Covid-19

2020 ◽  
Author(s):  
Kelly L. Bolton ◽  
Youngil Koh ◽  
Michael B. Foote ◽  
Hogune Im ◽  
Justin Jee ◽  
...  
Keyword(s):  
Somatic Mutations ◽  
Malignant Diseases ◽  
Tumor Patients ◽  
Hematopoietic Stem ◽  
Clonal Hematopoiesis ◽  
Increased Risk ◽  
Stem And Progenitor Cells ◽  
Severe Infections ◽  
The Relationship ◽  
Immunologic Profile

ABSTRACTAcquired somatic mutations in hematopoietic stem and progenitor cells (clonal hematopoiesis or CH) are associated with advanced age, increased risk of cardiovascular and malignant diseases, and decreased overall survival.1–4 These adverse sequelae may be mediated by altered inflammatory profiles observed in patients with CH.2,5,6 A pro-inflammatory immunologic profile is also associated with worse outcomes of certain infections, including SARS-CoV-2 and its associated disease Covid-19.7,8 Whether CH predisposes to severe Covid-19 or other infections is unknown. Among 515 individuals with Covid-19 from Memorial Sloan Kettering (MSK) and the Korean Clonal Hematopoiesis (KoCH) consortia, we found that CH was associated with severe Covid-19 outcomes (OR=1.9, 95%=1.2-2.9, p=0.01). We further explored the relationship between CH and risk of other infections in 14,211 solid tumor patients at MSK. CH was significantly associated with risk of Clostridium Difficile (HR=2.0, 95% CI: 1.2-3.3, p=6×10−3) and Streptococcus/Enterococcus infections (HR=1.5, 95% CI=1.1-2.1, p=5×10−3). These findings suggest a relationship between CH and risk of severe infections that warrants further investigation.

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