Treatment of severe infectious complications caused by multidrug-resistant Klebsiella pneumoniae in children with malignant neoplasms of the hematopoietic system: experience of the Research Institute of Pediatric Oncology and Hematology at N.N. Blokhin Russian Cancer Research Center

Introduction. So far there has been no clear protocol on the treatment of bacterial infections in hematopoietic cancer patients undergoing polychemotherapy (PCT) and hematopoietic stem cell transplantation (HSCT). Guidelines available from antibiotic therapy panels such as EMBT, NCCN, ECIL, Sepsis-3 often fail to cover the entire spectrum of clinical risk factors of severe complications caused specifically by multiresistant Klebsiella pneumoniae.The aim of the study — is to showcase the clinical experience of demonstration of the experience of the Research Institute of Pediatric Oncology and Hematology at N.N. Blokhin Russian Cancer Research Center with respect to adjusting antibacterial therapy for the spectrum of microorganisms found in the patient before the onset of antitumor therapy, and for the multiresistant microorganism findings in patients with blood cancers and febrile neutropenia (FN) undergoing PCT and HSCT.Materials and methods. The study involved five patients undergoing either PCT or HSCT for hematopoietic cancers at Research Institute of Pediatric Oncology and Hematology in October 2019 — October 2020, multiresistant Klebsiella pneumonia colonies found in each case. Results. Five patients with hematopoietic cancers and induced bone marrow aplasia were found to have multiresistant Klebsiella pneumoniae colonies on top of post-PCT/HSCT immunosuppression. Given high risk of death, these patients need early antibacterial therapy with reserve antibiotics outside standard empirical antibacterial treatment protocols should they develop FN. The Center's practices have shown that baseline protocols are often inadequate to the severity of these patients' conditions in a certain timeframe.Conclusions. To sum up the Center's limited experience, the finding is that additional research is required into the factors of risk of severe multiresistant Klebsiella pneumoniae infections in patients undergoing PCT and HSCT; algorithms must be developed for the treatment of patients in such a critical condition.

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INTEGRATION OF PRIMARY PALLIATIVE CARE AND PEDIATRIC ONCOLOGY SERVICES USING SHORT-TERM HOSPITAL FACILITIES: EXPERIENCE OF ONE CENTER

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-3-200-207 ◽

2021 ◽

Vol 100 (3) ◽

pp. 200-207

Author(s):

A.V. Pshonkin ◽

◽

E.V. Polevichenko ◽

A.G. Andruzskaya ◽

N.V. Zhukov ◽

...

Keyword(s):

Palliative Care ◽

Medical Research ◽

Pediatric Oncology ◽

Research Center ◽

Malignant Neoplasms ◽

Place Of Residence ◽

Short Term ◽

Short Term Treatment ◽

Pediatric Hematology ◽

National Medical

Objective of the study: to analyze children with various diagnoses of malignant neoplasms (MNs), who underwent treatment at the National Medical Research Center of Pediatric Hematology, Oncology, Immunology, recognized incurable due to the characteristics of the main disease, as well as determining the optimum approach in transferring the patient to the patronage of the palliative service in the place of residence. Materials and methods of research: the analysis included patients who were treated at the Rogachev National Medical Research Center of Pediatric Hematology, Oncology, Immunology from November 2018 to November 2020, – 116 patients aged 0 up to 18 years, who, in the course of their treatment, have been recognized incurable and discharged to the place of residence under the supervision of children's palliative services or left in the center for the severity of the condition. Results: the number of incurable patients at the National Medical Research Center of Pediatric Hematology, Oncology, Immunology for the period of the study was 116 (2,6%) out of 4,444 hospitalized. The majority – 99 (85%) of 116 patients – were discharged to their homes for palliative care. However, the algorithm developed at the center, which provides for the initial selection of the optimal palliative care regime in the hospital for short-term treatment, the assessment of risks of transport and its type (with or without medical personnel), made it possible to ensure safe transportation of all patients, as well as full control of symptoms during transportation. and at the first stages of the patient's stay at the place of residence. Subsequent palliative treatment of patients at the place of residence was also corrected, if necessary, with the participation of specialists of the center, either in person or by correspondence, which made it possible to provide adequate palliative therapy to all patients until the end of the need. Conclusion: early integration of primary palliative care into the activities of the Federal center providing specialized pediatric oncological care may be one of the successful models of interaction between pediatric oncology services and palliative care for children in the Russian Federation.

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Demographic and Clinical Study on Patients Referred to The National Cancer Research Center for Pap Smears

Iraqi Journal of Science ◽

10.24996/ijs.2018.59.4c.1 ◽

2018 ◽

Vol 59 (4C) ◽

Keyword(s):

Cancer Research ◽

Clinical Study ◽

Research Center ◽

Pap Smears

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IPILIMUMAB IN PATIENTS WITH DISSEMINATED MELANOMA: THE N.N. PETROV NATIONAL MEDICAL RESEARCH CENTER OF ONCOLOGY EXPANDED ACCESS PROGRAM EXPERIENCE

Problems in oncology ◽

10.37469/0507-3758-2018-64-3-388-393 ◽

2018 ◽

Vol 64 (3) ◽

pp. 388-393

Author(s):

Yekaterina Anokhina ◽

V. Rubinchik ◽

Yekaterina Yaremenko ◽

Gulfiya Teletaeva ◽

Dilorom Latipova ◽

...

Keyword(s):

Overall Survival ◽

Adverse Events ◽

Medical Research ◽

Research Center ◽

Expanded Access ◽

Risk Of Death ◽

National Medical ◽

Expanded Access Program ◽

Access Program

Ipilimumab (IPI) provides a ten-year overall survival in almost 20 % of selected patients participated in several phase II-III trials. However, the expanded access program (EAP) looks more like routine practice than like clinical trials& This is why the results of such application could be different. Here we present the long-term follow-up data of single center EAP. Ninety-six patients with disseminated melanoma progressing after at least one lines of drug therapy were included at the N.N. Petrov National Medical Research Center of Oncology. Sixty-seven (70 %) patients had stage IV M1c, 35 patients (36 %) had elevated LDH before initiating IPI therapy. All patients received IPI 3 mg / kg IV every 3 weeks for a maximum of 4 cycles. Totally, 320 cycles (mean - 3.3 per patient) were conducted. Grade 3-4 immuno-mediated adverse events (imAE) observed in 18 (19 %) patients. Three patients died of adverse events, possibly associated with ongoing therapy. The median time to progression was 3 (95 % CI, 2.4 to 3.5) mo., the median overall survival was 13 (95 % CI, 8.3 to17.6) mo. Previous immunotherapy with dendritic cell vaccines decreased the risk of death by 48 % (Log-rank p = 0.049). The wild type BRAF status increased three-year overall survival from 29 to 68 % (p = 0.042). Our data confirms long-term safety and efficacy of IPI in patients with pretreated disseminated melanoma in the close to real practice setting.

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