المؤلفون: Tsuchihashi K; Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan., Ito M; Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, Japan., Okumura Y; Department of Gastrointestinal and Medical Oncology, NHO Kyushu Cancer Center, Fukuoka, Japan., Nio K; Department of Medical Oncology, Hamanomachi Hospital, Fukuoka, Japan., Ozaki Y; Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Nishio H; Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan., Ichihara E; Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan., Miura Y; Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan., Endo M; Department of Orthopaedic Surgery, Kyushu University, Fukuoka, Japan., Yano S; Division of Clinical Oncology/Hematology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan., Maruyama D; Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan., Yoshinami T; Department of Breast and Endocrine Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan., Susumu N; Department of Obstetrics and Gynecology, International University of Health and Welfare Narita Hospital, Chiba, Japan., Takekuma M; Department of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan., Motohashi T; Department of Obstetrics and Gynecology, Tokyo Women's Medical University Hospital, Tokyo, Japan., Ochi N; Department of General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan., Kubo T; Department of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan., Uchino K; Department of Medical Oncology, NTT Medical Center Tokyo, Tokyo, Japan., Kimura T; Department of Urology, The Jikei University School of Medicine, Tokyo, Japan., Kamiyama Y; Department of Clinical Oncology/Hematology, The Jikei University School of Medicine, Tokyo, Japan., Nakao S; Department of Hematology, Faculty of Medicine, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan., Tamura S; Department of Hematology/Oncology, Wakayama Medical University, Wakayama, Japan., Nishimoto H; Department of Nursing, Okayama University Hospital, Okayama, Japan., Kato Y; Department of Drug Information, Faculty of Pharmaceutical Sciences, Shonan University of Medical Sciences, Kanagawa, Japan., Sato A; Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan., Takano T; Department of Breast Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Baba E; Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. baba.eishi.889@m.kyushu-u.ac.jp.

المصدر: International journal of clinical oncology [Int J Clin Oncol] 2024 Jun; Vol. 29 (6), pp. 700-705. Date of Electronic Publication: 2024 May 02.

نوع المنشور: Journal Article; Systematic Review

بيانات الدورية: Publisher: Springer-Verlag Tokyo Country of Publication: Japan NLM ID: 9616295 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-7772 (Electronic) Linking ISSN: 13419625 NLM ISO Abbreviation: Int J Clin Oncol Subsets: MEDLINE

مواضيع طبية MeSH: Granulocyte Colony-Stimulating Factor*/therapeutic use , Febrile Neutropenia*/drug therapy , Febrile Neutropenia*/chemically induced, Humans ; Neoplasms/drug therapy ; Neoplasms/complications ; Japan ; Chemotherapy-Induced Febrile Neutropenia/drug therapy ; Medical Oncology ; Practice Guidelines as Topic

مستخلص: Background: Febrile neutropenia represents a critical oncologic emergency, and its management is pivotal in cancer therapy. In several guidelines, the use of granulocyte colony-stimulating factor (G-CSF) in patients with chemotherapy-induced febrile neutropenia is not routinely recommended except in high-risk cases. The Japan Society of Clinical Oncology has updated its clinical practice guidelines for the use of G-CSF, incorporating a systematic review to address this clinical question.
Methods: The systematic review was conducted by performing a comprehensive literature search across PubMed, the Cochrane Library, and Ichushi-Web, focusing on publications from January 1990 to December 2019. Selected studies included randomized controlled trials (RCTs), non-RCTs, and cohort and case-control studies. Evaluated outcomes included overall survival, infection-related mortality, hospitalization duration, quality of life, and pain.
Results: The initial search yielded 332 records. Following two rounds of screening, two records were selected for both qualitative and quantitative synthesis including meta-analysis. Regarding infection-related mortality, the event to case ratio was 5:134 (3.73%) in the G-CSF group versus 6:129 (4.65%) in the non-G-CSF group, resulting in a relative risk of 0.83 (95% confidence interval, 0.27-2.58; p = 0.54), which was not statistically significant. Only median values for hospitalization duration were available from the two RCTs, precluding a meta-analysis. For overall survival, quality of life, and pain, no suitable studies were found for analysis, rendering their assessment unfeasible.
Conclusion: A weak recommendation is made that G-CSF treatment not be administered to patients with febrile neutropenia during cancer chemotherapy. G-CSF treatment can be considered for patients at high risk.
(© 2024. The Author(s) under exclusive licence to Japan Society of Clinical Oncology.)

المؤلفون: Flanigan JA; University of Pittsburgh School of Pharmacy, Pittsburgh, PA, USA., Yasuda M; IQVIA Inc, Plymouth Meeting, PA, USA., Chen CC; IQVIA Inc, Plymouth Meeting, PA, USA., Li EC; Sandoz Inc, Princeton, NJ, USA. edward-1.li@sandoz.com.

المصدر: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2024 May 23; Vol. 32 (6), pp. 373. Date of Electronic Publication: 2024 May 23.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer International Country of Publication: Germany NLM ID: 9302957 Publication Model: Electronic Cited Medium: Internet ISSN: 1433-7339 (Electronic) Linking ISSN: 09414355 NLM ISO Abbreviation: Support Care Cancer Subsets: MEDLINE

مواضيع طبية MeSH: Chemotherapy-Induced Febrile Neutropenia*/etiology , Chemotherapy-Induced Febrile Neutropenia*/economics, Humans ; Retrospective Studies ; Male ; Middle Aged ; Female ; United States ; Adult ; Aged ; Neoplasms/drug therapy ; Neoplasms/complications ; Patient Acceptance of Health Care/statistics & numerical data ; Health Care Costs/statistics & numerical data ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Young Adult ; Adolescent ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/economics ; Insurance, Health/statistics & numerical data ; Insurance, Health/economics ; Health Resources/statistics & numerical data ; Health Resources/economics

مستخلص: Purpose: Febrile neutropenia (FN) is a known side effect of chemotherapy, often requiring hospitalization. Economic burden increases with an FN episode and estimates of cost per episode should be updated from real-world data.
Methods: A retrospective claims analysis of FN episodes in patients with non-myeloid malignancies from 2014 to 2021 was performed in IQVIA PharMetrics® Plus database. FN episodes were defined as having same-day claims for neutropenia and fever or infection, plus antibiotic in outpatient settings, following a claim for chemotherapy; index date was defined as the first claim for neutropenia/fever/infection. Patients receiving bone marrow/stem cell transplant and CAR-T therapy were excluded, as were select hematologic malignancies or COVID-19. Healthcare utilization and costs were evaluated and described overall, by episode type (w/wo hospitalization), index year, malignancy type, NCI comorbidity score, and age group.
Results: 7,033 FN episodes were identified from 6,825 patients. Most episodes had a hospitalization (91.2%) and 86% of patients had ≥1 risk factor for FN. Overall, FN episodes had a mean (SD) FN-related cost of $25,176 ($39,943). Episodes with hospitalization had higher average FN-related costs versus those without hospitalization ($26,868 vs $7,738), and costs increased with comorbidity score (NCI=0: $23,095; NCI >0-2: $26,084; NCI ≥2: $26,851).
Conclusions: FN continues to be associated with significant economic burden, and varied by cancer type, comorbidity burden, and age. In this analysis, most FN episodes were not preceded by GCSF prophylaxis. The results of this study highlight the opportunity to utilize GCSF in appropriate oncology scenarios.
(© 2024. The Author(s).)

المؤلفون: Ige G; The Queen's Cancer Center, Queen's Medical Center, Honolulu, HI (GI, PA)., Adena P; The Queen's Cancer Center, Queen's Medical Center, Honolulu, HI (GI, PA)., Choi SY; John A. Burns School of Medicine, University of Hawai'i at Mānoa, Honolulu, HI (SYC).

المصدر: Hawai'i journal of health & social welfare [Hawaii J Health Soc Welf] 2024 Jun; Vol. 83 (6), pp. 152-157.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: University Health Partners of Hawaiʻi Country of Publication: United States NLM ID: 101750601 Publication Model: Print Cited Medium: Internet ISSN: 2641-5224 (Electronic) Linking ISSN: 26415216 NLM ISO Abbreviation: Hawaii J Health Soc Welf Subsets: MEDLINE

مواضيع طبية MeSH: Emergency Service, Hospital*/statistics & numerical data , Emergency Service, Hospital*/organization & administration , Febrile Neutropenia*/drug therapy , Febrile Neutropenia*/complications , Neoplasms*/complications, Humans ; Female ; Male ; Hawaii/epidemiology ; Middle Aged ; Pilot Projects ; Aged ; Waiting Lists ; Adult ; Time Factors ; Time-to-Treatment/statistics & numerical data

مستخلص: This pilot study examined differences in wait times for oncology patients who presented to the emergency department, with or without a Fast Pass, for febrile neutropenia (FN). Inadequate circulating neutrophils create a health risk for FN patients. An increased number of patients are receiving chemotherapy in an outpatient setting and may experience delays when seeking treatment in the emergency department. These delays in treatment may be due to overcrowding, patients who require life-saving medical interventions, and inconsistencies in recognizing febrile neutropenia, where fever may be the only presenting sign. The purpose of this study was to measure the impact on wait times, increasing possible risk of bacterial or viral exposure in the emergency department waiting room, for patients with a potential diagnosis of FN who presented their "Fast Pass" from the hospital cancer center's program upon arrival. Electronic medical records were reviewed over a period of 21 months, comparing wait times in the ED for oncology patients with potential FN before and after implementation of the Fast Pass program at an urban medical center in Hawai'i. Of the 1300 oncology patient chart reviews conducted, 6 patients met the study-defined inclusion criteria pre-Fast Pass and 10 met the study-defined inclusion criteria post-Fast Pass. Influence of the use of a Fast Pass on patient wait times was tested using a multivariate regression adjusted for ED patient volume. There were no differences in overall wait times pre- and post-Fast Pass.
Competing Interests: None of the authors identify a conflict of interest.
(©Copyright 2024 by University Health Partners of Hawai‘i (UHP Hawai‘i).)

المؤلفون: Chang VKO; School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia. Electronic address: victor.chang@health.qld.gov.au., Liang ES; Radiology and Imaging Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia., Schmidt P; Radiology and Imaging Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

المصدر: Current problems in diagnostic radiology [Curr Probl Diagn Radiol] 2024 May-Jun; Vol. 53 (3), pp. 341-345. Date of Electronic Publication: 2024 Jan 20.

نوع المنشور: Observational Study; Journal Article

بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 7607123 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-6302 (Electronic) Linking ISSN: 03630188 NLM ISO Abbreviation: Curr Probl Diagn Radiol Subsets: MEDLINE

مواضيع طبية MeSH: Neoplasms* , Sinusitis*/complications , Febrile Neutropenia*/diagnostic imaging , Febrile Neutropenia*/complications, Adult ; Humans ; Tomography, X-Ray Computed/methods ; Medical Oncology ; Retrospective Studies

مستخلص: Background: Computed tomography (CT) imaging has become a first line investigation for most cases of febrile neutropenia (FN) which can be the only sign of infection in oncology patients undergoing active chemotherapy and bone marrow transplants. The utility of routine non-targeted imaging remains unclear.
Objective: To assess and compare the diagnostic rate between targeted, non-targeted and pan-scan CT in identifying an acute source of infection in adult oncology patients with FN.
Materials and Methods: A retrospective observational study was conducted between February 2019 and March 2023 on 417 consecutive CT examinations for the clinical indication of source identification in FN. Scans were noted for the anatomical regions that were imaged and reports were classified as positive, negative or equivocal for infection. Pre-existing pathology was also noted. Results were tabulated and statistical analyses for comparison between groups of scans was performed using chi-square test.
Results: All targeted regional scans had statistically significant difference in positive rate compared to non-targeted scans of the respective region; chest (Χ²(1)=18.11, P<.001); sinus (Χ²(1)=15.36, P<.001); abdomen and pelvis (Χ²(1)=5.95, P=.01). Pneumonia (41.3 %) was much more likely to be the diagnosis compared to sinusitis (16.2 %) in concomitant CT chest to sinus examinations (Χ²(1)=45.3, P<.001). Pan-scans had a higher incidence of positive diagnosis compared to all-targeted scans (Χ²(1)=4.91, P=.03) but when compared to higher yield targeted scans (abdomen and chest), there was no statistical difference (Χ²(1)=2.43, P=.12). 20/54 patients had pan-scans despite having localising symptoms.
Conclusion: Imaging guided by presenting signs and symptoms can help to reduce unnecessary imaging and promote more judicious use of non-targeted and pan-scan CT in current practices.
Competing Interests: Declaration of competing interest Authors of this manuscript have are no conflicts of interest to disclose or declare relevant to this submission
(Copyright © 2024. Published by Elsevier Inc.)

المؤلفون: Polat MC; Department of Pediatrics, Ankara Bilkent City Hospital, The University of Health Sciences, Ankara, Turkey. mervegulerpolat@gmail.com., Sönmez Ç; Department of Medical Biochemistry, Dr.Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey., Yarali N; Department of Pediatric Hematology/Oncology, Ankara Bilkent City Hospital, Yıldırım Beyazıt University, Ankara, Turkey., Özbek NY; Department of Pediatric Hematology/Oncology, Ankara Bilkent City Hospital, The University of Health Sciences, Ankara, Turkey.

المصدر: European journal of pediatrics [Eur J Pediatr] 2024 May; Vol. 183 (5), pp. 2155-2162. Date of Electronic Publication: 2024 Feb 17.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Springer Verlag Country of Publication: Germany NLM ID: 7603873 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1076 (Electronic) Linking ISSN: 03406199 NLM ISO Abbreviation: Eur J Pediatr Subsets: MEDLINE

مواضيع طبية MeSH: Interleukin-33*/blood , Interleukin-1 Receptor-Like 1 Protein*/blood , Febrile Neutropenia*/blood , Febrile Neutropenia*/etiology , Febrile Neutropenia*/diagnosis , Biomarkers*/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma*/blood , Precursor Cell Lymphoblastic Leukemia-Lymphoma*/complications, Humans ; Female ; Male ; Child ; Prospective Studies ; Case-Control Studies ; Child, Preschool ; Adolescent ; Infant ; Bacterial Infections/blood ; Bacterial Infections/diagnosis

مستخلص: The purpose of this study was to evaluate the association between interleukin-33 (IL-33) and its receptor Soluble Suppression of Tumorigenicity-2 (sST2) levels and bacterial infections during febrile neutropenia (FN) in pediatric patients with acute lymphoblastic leukemia (ALL). In this prospective, case-control study, participants were divided into 3 groups: ALL patients with FN (Group A), ALL patients without neutropenia and fever (Group B), and healthy children without infection and chronic disease (Group C). There were 30 cases in each group. Blood samples for IL-33 and sST2 have been drawn from patients in Group A before the initiation of treatment and on days 1 and 5 of treatment, and from patients in Groups B and C at initiation. At admission, mean IL-33 level (39.02 ± 26.40 ng/L) in Group B and mean sST2 level (185.3 ± 371.49 ng/ml) in Group A were significantly higher than the other groups (p = 0.038, p < 0.001, respectively). No difference was observed in the mean IL-33 and sST2 levels in the 5-day follow-up of patients in Group A (p = 0.82, p = 0.86, respectively). IL-33 and sST2 levels were not associated with fever duration, neutropenia duration or length of hospitalization. While C-reactive protein (CRP) was significantly higher in patients with positive blood culture (p = 0.021), IL-33 (p = 0.49) and sST2 (p = 0.21) levels were not associated with culture positivity.  Conclusion: IL-33 and sST2 levels were not found valuable as diagnostic and prognostic markers to predict bacterial sepsis in patients with FN. What is Known: • Neutropenic patients are at high risk of serious bacterial and viral infections, but the admission symptom is often only fever. • Febrile neutropenia has a high mortality rate if not treated effectively. What is New: • Febrile neutropenia is not only caused by bacterial infections. Therefore, new biomarkers should be identified to prevent overuse of antibiotics. • Specific biomarkers are needed to diagnose bacterial sepsis in the early phase of febrile neutropenia.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

المؤلفون: Wang YW; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.; School of Pharmacy, College of Medicine, National Taiwan University, 33, Linsen S. Rd, Room 216, Taipei, Taiwan., Hou HA; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Lin CC; Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan., Lin HY; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan., Chen PZ; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan., Kuo CH; School of Pharmacy, College of Medicine, National Taiwan University, 33, Linsen S. Rd, Room 216, Taipei, Taiwan., Chiu HH; School of Pharmacy, College of Medicine, National Taiwan University, 33, Linsen S. Rd, Room 216, Taipei, Taiwan.; Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan., Chuang CC; School of Pharmacy, College of Medicine, National Taiwan University, 33, Linsen S. Rd, Room 216, Taipei, Taiwan.; Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan., Chen YJ; Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan., Lin SW; School of Pharmacy, College of Medicine, National Taiwan University, 33, Linsen S. Rd, Room 216, Taipei, Taiwan. shuwenlin@ntu.edu.tw.; Graduate Institute of Clinical Pharmacy, National Taiwan University, Taipei, Taiwan. shuwenlin@ntu.edu.tw.; National Taiwan University Cancer Center, Taipei, Taiwan. shuwenlin@ntu.edu.tw.

المصدر: Advances in therapy [Adv Ther] 2024 Jul; Vol. 41 (7), pp. 2966-2977. Date of Electronic Publication: 2024 May 14.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Health Communications Inc Country of Publication: United States NLM ID: 8611864 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1865-8652 (Electronic) Linking ISSN: 0741238X NLM ISO Abbreviation: Adv Ther Subsets: MEDLINE

مواضيع طبية MeSH: Teicoplanin*/administration & dosage , Teicoplanin*/therapeutic use , Teicoplanin*/pharmacokinetics , Hematologic Neoplasms*/complications , Hematologic Neoplasms*/drug therapy , Anti-Bacterial Agents*/therapeutic use , Anti-Bacterial Agents*/administration & dosage , Anti-Bacterial Agents*/pharmacokinetics , Drug Monitoring*/methods , Febrile Neutropenia*/drug therapy, Humans ; Male ; Female ; Middle Aged ; Prospective Studies ; Aged ; Adult ; Dose-Response Relationship, Drug ; Treatment Outcome ; Young Adult

مستخلص: Introduction: A target trough concentration (C min ) of teicoplanin ≥ 15-20 mg/L between the fourth and sixth day has been suggested for severe infections or management of febrile neutropenia (FN). Owing to no reports discussing the impact of early target attainment on treatment outcomes, this study aimed to evaluate the dose-C min relationship and clinical outcome and estimate the optimal early target C min for FN in patients with hematological malignancies.
Methods: This single-center, prospective study enrolled patients with hematological malignancies who were treated with teicoplanin either as an empirical antibiotic for FN or as targeted treatment for Gram-positive bacteria. Blood samples were collected on day three (48 h) post-loading doses, day 5 (96 h), and day 8 (when applicable) and determined by ultrahigh-pressure liquid chromatography-triple quadruple mass spectrometry. A total of 117 samples from 47 patients with FN (27 men, 20 women) were consecutively analyzed. A two-tailed α value of 0.05 was considered statistically significant.
Results: The mean C min values at 48 h, 96 h, and on day 8 were 23.4, 21.4, and 27.8 mg/L, respectively. The patients achieving C min  ≥ 20 mg/L at 48 h had a higher likelihood of treatment success. The areas under the receiver operating characteristic curves were 0.71 for clinical efficacy and the cutoff value of C min at 48 h was 18.85 mg/L (95% confidence interval 0.55-0.87; P = 0.018).
Conclusions: The C min of teicoplanin after completion of loading doses could predict the treatment response, with a target concentration ≥ 18.85 mg/L.
(© 2024. The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature.)

المؤلفون: Kobayashi R; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan. Electronic address: r-koba@jacls.jp., Sano H; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan., Matsushima S; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan., Hori D; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan., Yanagi M; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan., Suzuki D; Department of Hematology/Oncology for Children and Adolescents, Sapporo Hokuyu Hospital, Japan.

المصدر: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy [J Infect Chemother] 2024 Jul; Vol. 30 (7), pp. 642-645. Date of Electronic Publication: 2024 Jan 30.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 9608375 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1437-7780 (Electronic) Linking ISSN: 1341321X NLM ISO Abbreviation: J Infect Chemother Subsets: MEDLINE

مواضيع طبية MeSH: Bacteremia*/drug therapy , Bacteremia*/microbiology , Anti-Bacterial Agents*/therapeutic use , Febrile Neutropenia*/drug therapy , Febrile Neutropenia*/microbiology, Humans ; Retrospective Studies ; Child ; Adolescent ; Female ; Male ; Child, Preschool ; Infant ; Microbial Sensitivity Tests ; Incidence

مستخلص: Background: Control of bacterial and fungal infections is critical to improving outcomes in hematological neoplastic diseases of children and adolescents. In this study, a retrospective analysis of our previous studies on febrile neutropenia was performed to investigate bacteremia.
Procedure: From August 2008 to December 2023, five antibiotic studies were performed for febrile and neutropenic pediatric patients who had been treated with chemotherapy, immunosuppressive therapy, or had received stem cell transplantation in the pediatric unit at Sapporo Hokuyu Hospital. The rate of positive blood culture, detected bacteria, and susceptibility of several types of antibiotics in febrile episodes were investigated.
Results: Blood culture was positive in 133 of 1604 febrile episodes of 329 patients. Detected bacteria were Gram-positive cocci (61.2 %), Gram-negative bacilli (27.6 %), Gram-negative cocci (0.7 %), and Gram-positive bacilli (10.4 %). The incidence of bacteremia over time showed a decreasing trend with each passing year. In particular, the incidence of bacteremia was around 10 % in 2008-2013, whereas it was often below 5 % after 2020; this decrease was statistically significant. Although almost all detected bacteria and their susceptibilities to antibiotics (piperacillin/tazobactam, meropenem, ceftazidime, and cefozopran) did not change over time, all Escherichia coli detected after 2014 were extended-spectrum β-lactamase-producing bacteria.
Competing Interests: Declaration of competing interest All authors declare that there are no conflicts of interest to disclose.
(Copyright © 2024 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

المؤلفون: Tseng TH; Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan., Chiang SC; Department of Pharmacy, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University (Yang Ming Campus), Taipei, Taiwan.; Center for Advanced Pharmacy Education, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan., Hsu JC; International PhD Program in Biotech and Healthcare Management, College of Management, Taipei Medical University, Taipei, Taiwan., Ko Y; Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.; Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.

المصدر: PloS one [PLoS One] 2024 Jun 10; Vol. 19 (6), pp. e0303294. Date of Electronic Publication: 2024 Jun 10 (Print Publication: 2024).

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

مواضيع طبية MeSH: Breast Neoplasms*/drug therapy , Cost-Benefit Analysis* , Granulocyte Colony-Stimulating Factor*/therapeutic use , Granulocyte Colony-Stimulating Factor*/economics , Chemotherapy-Induced Febrile Neutropenia*/prevention & control , Chemotherapy-Induced Febrile Neutropenia*/economics , Chemotherapy-Induced Febrile Neutropenia*/etiology , Quality-Adjusted Life Years*, Humans ; Female ; Taiwan/epidemiology ; Markov Chains ; Filgrastim/therapeutic use ; Filgrastim/economics ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/economics ; Antineoplastic Agents/therapeutic use ; Cost-Effectiveness Analysis ; Polyethylene Glycols

مستخلص: Objectives: To examine the cost-effectiveness of using granulocyte colony-stimulating factor (G-CSF) for primary or secondary prophylaxis in patients with breast cancer from the perspective of Taiwan's National Health Insurance Administration.
Methods: A Markov model was constructed to simulate the events that may occur during and after a high-risk chemotherapy treatment. Various G-CSF prophylaxis strategies and medications were compared in the model. Effectiveness data were derived from the literature and an analysis of the National Health Insurance Research Database (NHIRD). Cost data were obtained from a published NHIRD study, and health utility values were also obtained from the literature. Sensitivity analyses were performed to assess the uncertainty of the cost-effectiveness results.
Results: In the base-case analysis, primary prophylaxis with pegfilgrastim had an incremental cost-effectiveness ratio (ICER) of NT$269,683 per quality-adjusted life year (QALY) gained compared to primary prophylaxis with lenograstim. The ICER for primary prophylaxis with lenograstim versus no G-CSF prophylaxis was NT$61,995 per QALY gained. The results were most sensitive to variations in relative risk of febrile neutropenia (FN) for pegfilgrastim versus no G-CSF prophylaxis. Furthermore, in the probabilistic sensitivity analysis, at a willingness-to-pay threshold of one times Taiwan's gross domestic product per capita, the probability of being cost-effective was 88.1% for primary prophylaxis with pegfilgrastim.
Conclusions: Our study suggests that primary prophylaxis with either short- or long-acting G-CSF could be considered cost-effective for FN prevention in breast cancer patients receiving high-risk regimens.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Tseng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

المؤلفون: Wang X; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Zhang H; School of Pharmacy, Chengdu Medical College, Chengdu, China.; Department of Pharmacy, Chengdu Eighth People's Hospital, Chengdu, China., Zhang N; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Zhang S; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Shuai Y; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Miao X; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Liu Y; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Qiu L; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Ren S; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Lai S; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Han Y; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Yao H; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Zhang X; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Fan F; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Sun H; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China., Yi H; Department of Hematology, The General Hospital of Western Theater Command, Chengdu, China.

المصدر: Frontiers in cellular and infection microbiology [Front Cell Infect Microbiol] 2024 Apr 25; Vol. 14, pp. 1366908. Date of Electronic Publication: 2024 Apr 25 (Print Publication: 2024).

نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101585359 Publication Model: eCollection Cited Medium: Internet ISSN: 2235-2988 (Electronic) Linking ISSN: 22352988 NLM ISO Abbreviation: Front Cell Infect Microbiol Subsets: MEDLINE

مواضيع طبية MeSH: Metagenomics*/methods , High-Throughput Nucleotide Sequencing*/methods , Febrile Neutropenia*/microbiology , Febrile Neutropenia*/blood , Febrile Neutropenia*/diagnosis, Humans ; Male ; Retrospective Studies ; Female ; Middle Aged ; Adult ; Aged ; Young Adult ; Adolescent ; Aged, 80 and over ; Bacterial Infections/diagnosis ; Bacterial Infections/microbiology ; Bacteria/genetics ; Bacteria/isolation & purification ; Bacteria/classification ; Mycoses/diagnosis ; Mycoses/microbiology ; Virus Diseases/diagnosis ; Virus Diseases/virology

مستخلص: Background: Metagenomic next-generation sequencing (mNGS) is a novel non-invasive and comprehensive technique for etiological diagnosis of infectious diseases. However, its practical significance has been seldom reported in the context of hematological patients with high-risk febrile neutropenia, a unique patient group characterized by neutropenia and compromised immune responses.
Methods: This retrospective study evaluated the results of plasma cfDNA sequencing in 164 hematological patients with high-risk febrile neutropenia. We assessed the diagnostic efficacy and clinical impact of mNGS, comparing it with conventional microbiological tests.
Results: mNGS identified 68 different pathogens in 111 patients, whereas conventional methods detected only 17 pathogen types in 36 patients. mNGS exhibited a significantly higher positive detection rate than conventional methods (67.7% vs . 22.0%, P < 0.001). This improvement was consistent across bacterial (30.5% vs . 9.1%), fungal (19.5% vs . 4.3%), and viral (37.2% vs . 9.1%) infections ( P < 0.001 for all comparisons). The anti-infective treatment strategies were adjusted for 51.2% (84/164) of the patients based on the mNGS results.
Conclusions: mNGS of plasma cfDNA offers substantial promise for the early detection of pathogens and the timely optimization of anti-infective therapies in hematological patients with high-risk febrile neutropenia.
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
(Copyright © 2024 Wang, Zhang, Zhang, Zhang, Shuai, Miao, Liu, Qiu, Ren, Lai, Han, Yao, Zhang, Fan, Sun and Yi.)

المؤلفون: Miura K; Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan., Yamaguchi O; Department of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, 350-1298, Japan. ouyamagu@saitama-med.ac.jp., Mori K; Clinical Research Center, Shizuoka Cancer Center, Nagaizumi, Japan., Nakamura A; Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan., Tamiya M; Department of Thoracic Oncology, Osaka International Cancer Institute, Osaka, Japan., Oba T; Department of Respiratory Medicine, Saitama Red Cross Hospital, Saitama, Japan., Yanagitani N; Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan., Mizutani H; Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan., Ninomiya T; Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan., Kajiwara T; Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan., Ito K; Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Mie, Japan., Miyanaga A; Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan., Arai D; Department of Internal Medicine, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan., Kodama H; Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan., Kobayashi K; Department of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, 350-1298, Japan., Kaira K; Department of Respiratory Medicine, Comprehensive Cancer Center, Saitama Medical University International Medical Center, 1397-1, Yamane, Hidaka, 350-1298, Japan. kkaira1970@yahoo.co.jp.

المصدر: Scientific reports [Sci Rep] 2024 Feb 15; Vol. 14 (1), pp. 3816. Date of Electronic Publication: 2024 Feb 15.

نوع المنشور: Journal Article

بيانات الدورية: Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

مواضيع طبية MeSH: Carcinoma, Non-Small-Cell Lung*/etiology , Lung Neoplasms*/etiology , Leukopenia*/chemically induced , Febrile Neutropenia*/chemically induced , Febrile Neutropenia*/prevention & control , Febrile Neutropenia*/drug therapy , Filgrastim*, Humans ; Ramucirumab ; Docetaxel ; Polyethylene Glycols/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Granulocyte Colony-Stimulating Factor/therapeutic use

مستخلص: Ramucirumab plus docetaxel (RD) can cause febrile neutropenia (FN), which frequently requires the prophylactic administration of pegfilgrastim. However, the effects of prophylactic pegfilgrastim on FN prevention, therapeutic efficacy, and prognosis after RD have not been fully evaluated in patients with advanced non-small-cell lung cancer (NSCLC). Two hundred and eighty-eight patients with advanced NSCLC who received RD as second-line therapy after platinum-based chemotherapy plus PD-1 blockade were included. Patients were divided into groups with and without prophylactic pegfilgrastim, and adverse events, efficacy, and prognosis were compared between both groups. Of the 288 patients, 247 received prophylactic pegfilgrastim and 41 did not. The frequency of grade 3/4 neutropenia was 62 patients (25.1%) in the pegfilgrastim group and 28 (68.3%) in the control group (p < 0.001). The frequency of FN was 25 patients (10.1%) in the pegfilgrastim group and 10 (24.4%) in the control group (p = 0.018). The objective response rate was 31.2% and 14.6% in the pegfilgrastim and control groups (p = 0.039), respectively. The disease control rate was 72.9% in the pegfilgrastim group and 51.2% in the control group (p = 0.009). Median progression free survival was 4.3 months in the pegfilgrastim group and 2.5 months in the control group (p = 0.002). The median overall survival was 12.8 and 8.1 months in the pegfilgrastim and control groups (p = 0.004), respectively. Prophylactic pegfilgrastim for RD reduced the frequency of grade 3/4 neutropenia and febrile neutropenia and did not appear to be detrimental to patient outcome RD.Clinical Trial Registration Number: UMIN000042333.
(© 2024. The Author(s).)