Article
Oncology
Mauro Passucci, Chiara Masucci, Francesca Paoletti, Claudia Ielo, Alessandro Costa, Ida Carmosino, Emilia Scalzulli, Maurizio Martelli, Giuseppe Gentile, Massimo Breccia
Summary: Patients with hematological malignancies and past serological evidence of hepatitis B are at risk for HBV reactivation. The use of the JAK 1/2 inhibitor ruxolitinib in myeloproliferative neoplasms carries a moderate risk of reactivation (1-10%), but there is no strong evidence to recommend HBV prophylaxis in these patients. This case report highlights the potential need for continued HBV prophylaxis in patients receiving ruxolitinib treatment.
FRONTIERS IN ONCOLOGY
(2023)
Review
Biology
Iwona Hus, Agnieszka Szymczyk, Joanna Manko, Joanna Drozd-Sokolowska
Summary: The COVID-19 pandemic had a significant impact on clinical outcomes and management of patients with hematological malignancies, who are highly susceptible to infections. High mortality rates were observed among these patients, especially when infected with the highly virulent wild-type strain of SARS-CoV-2. Prevention measures such as wearing masks and practicing physical distancing and hand hygiene were advised, and outpatient treatment with oral drugs was preferred to avoid hospitalization whenever possible. Despite these measures, many patients died from COVID-19 or related complications. Vaccination, mask-wearing, and avoiding poorly ventilated or crowded places are recommended for these patients. The introduction of global vaccination strategies has reduced the risk of COVID-19 in the general population, but elderly, multi-morbid, and immunocompromised patients still face a higher risk of severe illness and death. Prompt antiviral treatment is recommended for positive cases. The COVID-19 pandemic has been the most challenging health crisis of the 21st century, leading to significant research on mRNA vaccines and new antiviral drugs. The paper presents the increased susceptibility and evolving clinical course of COVID-19 in patients with hematological malignancies, considering virus mutations and the introduction of vaccines and antiviral drugs. Current recommendations for prophylactic and therapeutic management in these patients are also discussed. Rating: 9/10.
Article
Infectious Diseases
Didi Bury, Tom F. W. Wolfs, Rob Ter Heine, Eline W. Muilwijk, Wim J. E. Tissing, Roger J. Bruggemann
Summary: The study determined the pharmacokinetics of twice-a-week micafungin prophylaxis in paediatric leukaemic patients to provide the rationale for this approach. The simulations showed that all twice-a-week regimens resulted in adequate exposure for Candida therapy, with exposures well above those in adults.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2022)
Article
Immunology
Eduard Schulz, Silke Grumaz, Stefan Hatzl, Maximilian Gornicec, Thomas Valentin, Bianca Huber-Krassnitzer, Lisa Kriegl, Barbara Uhl, Alexander Deutsch, Hildegard Greinix, Robert Krause, Peter Neumeister
Summary: This study validated the high sensitivity and broader pathogen spectrum of mNGS in detecting pathogens in patients with febrile neutropenia. The consistency between blood culture (BC) and mNGS was relatively low.
OPEN FORUM INFECTIOUS DISEASES
(2022)
Article
Medicine, General & Internal
Edoardo Benedetti, Benedetto Bruno, Francesca Martini, Riccardo Morganti, Emilia Bramanti, Francesco Caracciolo, Sara Galimberti, Piero Lippolis, Emanuele Neri, Chiara Arena, Francesca Cerri, Vittorio Ricchiuto, Matteo Pelosini, Enrico Orciuolo, Mario Petrini
Summary: NEC is a life-threatening complication following chemotherapy with high mortality rates. Early diagnosis is crucial to improve outcomes. Bedside ultrasound is a non-invasive and radiation-free imaging technique for early diagnosis of NEC and its prompt treatment significantly reduced mortality.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Infectious Diseases
Shuyun Wang, Yan Song, Nan Shi, Donghong Yin, Jianbang Kang, Wanni Cai, Jinju Duan
Summary: The aim of this study was to investigate the current epidemiology, changes during the study years, and inflammatory biomarkers of bacterial bloodstream infections (BSIs) in neutropenic patients with hematological malignancies. Gram-negative organisms, particularly Escherichia coli, were the predominant causes of BSI. Risk factors for mortality and multidrug-resistant gram-negative BSI were identified. Procalcitonin, absolute neutrophil count, and white blood cell demonstrated higher diagnostic accuracy for BSIs.
INFECTION AND DRUG RESISTANCE
(2023)
Review
Hematology
Khai Li Chai, Jonathan Wong, Robert Weinkove, Anastazia Keegan, Philip Crispin, Simon Stanworth, C. Orla Morrissey, Erica M. Wood, Zoe K. McQuilten
Summary: Acquired hypogammaglobulinemia is common in CLL, NHL, and MM patients. This study aimed to evaluate the efficacy and safety of prophylactic immunoglobulin, antibiotics, and vaccination in preventing infection. The results showed that prophylactic immunoglobulin and vaccination reduced the risk of infection, while prophylactic antibiotics did not have a significant effect.
Article
Dermatology
Francisco Lopez-Medrano, Maria Munoz de la Espada, Maria Asuncion Perez-Jacoiste Asin, Mario Fernandez-Ruiz, Juan Maria Herrero-Martinez, Jesus Alonso-Carrillo, Rafael San Juan, Isabel Rodriguez-Goncer, Amado Andres, Esther Gonzalez, Alejandro Manrique, Iago Justo, Alberto Marcacuzco, Carmelo Loinaz, Carlos Jimenez, Carlos Lumbreras, Jose Maria Aguado
Summary: This single-center retrospective study compared the incidence of invasive candidiasis among 218 pancreas transplant recipients under two different antifungal prophylaxis regimens. The study did not find a significant benefit from the initial use of micafungin-based prophylaxis over fluconazole in terms of invasive candidiasis.
Article
Medicine, General & Internal
Aleksandra Lanocha, Natalia Lanocha-Arendarczyk, Dominika Wilczynska, Barbara Zdziarska, Danuta Kosik-Bogacka
Summary: This study aimed to evaluate the frequency of gastrointestinal protozoan infection in patients with hematological malignancies undergoing intensive treatment and to determine the biological factors influencing intestinal parasite infection. The results showed a higher prevalence of parasitic infections in patients with hematological malignancies undergoing treatment.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Dermatology
Andrew M. Strand, Barbara D. Alexander, Eric Sarpong, Jessica Retuerto Wong, Ashley Engemann, David Rizzieri, Yuan Wu, Melissa D. Johnson
Summary: Duke University Hospital implemented a standardized antifungal prophylaxis protocol, which significantly increased the use of antifungal prophylaxis among patients undergoing induction chemotherapy. Lack of antifungal prophylaxis and older age were identified as risk factors for invasive fungal infections.
Article
Biophysics
Stephen Maurer, Kathleen A. Linder, Carol A. Kauffman, Philip McDonald, Jonathan T. Arcobello, Jon Karl D. Velasco, Pranatharthi Chandrasekar, Sanjay Revankar, Marisa H. Miceli
Summary: We conducted a retrospective review of the infectious complications and outcomes over a 2-year follow-up period of adult patients who received a second allogeneic hematopoietic cell transplant (2nd allo-HCT) during a five-year period at two cancer centers in Michigan. Sixty patients, of whom 44 (73%) had acute leukemia or myelodysplastic syndrome, were studied. The majority (n = 37,62%) received a 2nd allo-HCT because of relapsed leukemia. Infection episodes after the 2nd allo-HCT totaled 112. Bacteria were identified in 76 episodes, the majority of which occurred pre-engraftment. The most common infecting organisms were Enterococcus species and Clostridioides difficile. Viral infections, predominantly cytomegalovirus, accounted for 59 infection episodes and occurred mostly in pre-engraftment and early post-engraftment periods. There were 16 proven/probable fungal infections, of which 9 were invasive aspergillosis or candidiasis. Mortality was 45% (n = 27) at one year and 65% (n = 39) at 2 years after transplant, and 16 deaths (41%) were due to infection. Of those 16 infection deaths, 8 were bacterial, 4 fungal, 2 both bacterial and fungal, and 2 viral. Failure to engraft neutrophils or platelets was significantly associated with decreased survival, p < 0.0001 and p < 0.001, respectively. Infections are common after a 2nd allo-HCT and are associated with a high mortality rate.
BONE MARROW TRANSPLANTATION
(2022)
Article
Immunology
Juliana Ochoa-Grullon, Celina Benavente Cuesta, Ataulfo Gonzalez Fernandez, Gustavo Cordero Torres, Cristina Perez Lopez, Ascension Pena Cortijo, Laura Conejero Hall, Marta Mateo Morales, Antonia Rodriguez de la Pena, Carmen M. Diez-Rivero, Edgard Rodriguez de Frias, Kissy Guevara-Hoyer, Miguel Fernandez-Arquero, Silvia Sanchez-Ramon
Summary: The study demonstrates that MV130 can reduce infection rate and enhance humoral immune responses in vulnerable patients.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Oncology
Huilan Zeng, Zhuman Wu, Bing Yu, Bo Wang, Chengnian Wu, Jie Wu, Jing Lai, Xiaoyan Gao, Jie Chen
Summary: Posaconazole may be an optimal prophylaxis agent as it reduced IFIs, all-cause mortality, and adverse events, despite no significant difference in the need for empirical treatment and the proportion of successful treatment.
Article
Dermatology
Sebastian M. Wingen-Heimann, Oliver A. Cornely, Maria J. G. T. Vehreschild, Hilmar Wisplinghoff, Bernd Franke, Max Schons, Michael von Bergwelt-Baildon, Christof Scheid, Joerg Janne Vehreschild
Summary: This study analyzed the clinical and economic impact of using continuous micafungin as antifungal prophylaxis following aSCT. The results showed improved outcomes in patients who received only micafungin compared to those who received both posaconazole and micafungin, potentially due to a lower incidence of probable/proven IFD. Despite the higher drug acquisition costs of micafungin, it did not result in higher overall treatment costs.
Article
Oncology
Choi Wan Chan, Alex Molassiotis, Harold K. K. Lee
Summary: In leukemia patients undergoing chemotherapy, the use of antimicrobial prophylaxis did not significantly affect the levels of CRP and PCT, as well as the immediate outcome measures of NF. While there were no statistically significant differences between the two groups, patients with antimicrobial prophylaxis tended to have higher median fever duration, CRP and PCT values, and a higher proportion of NF requiring modification of antibiotics.
SUPPORTIVE CARE IN CANCER
(2021)