Neutropenia: A decrease in the number of NEUTROPHILS found in the blood.Autoimmune Diseases: Disorders that are characterized by the production of antibodies that react with host tissues or immune effector cells that are autoreactive to endogenous peptides.Agranulocytosis: A decrease in the number of GRANULOCYTES; (BASOPHILS; EOSINOPHILS; and NEUTROPHILS).Autoantibodies: Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them.Neutrophils: Granular leukocytes having a nucleus with three to five lobes connected by slender threads of chromatin, and cytoplasm containing fine inconspicuous granules and stainable by neutral dyes.Febrile Neutropenia: Fever accompanied by a significant reduction in the number of NEUTROPHILS.Chemotherapy-Induced Febrile Neutropenia: FEVER accompanied by a significant reduction in NEUTROPHIL count associated with CHEMOTHERAPY.Fever: An abnormal elevation of body temperature, usually as a result of a pathologic process.Granulocyte Colony-Stimulating Factor: A glycoprotein of MW 25 kDa containing internal disulfide bonds. It induces the survival, proliferation, and differentiation of neutrophilic granulocyte precursor cells and functionally activates mature blood neutrophils. Among the family of colony-stimulating factors, G-CSF is the most potent inducer of terminal differentiation to granulocytes and macrophages of leukemic myeloid cell lines.Antineoplastic Combined Chemotherapy Protocols: The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Taxoids: A group of diterpenoid CYCLODECANES named for the taxanes that were discovered in the TAXUS tree. The action on MICROTUBULES has made some of them useful as ANTINEOPLASTIC AGENTS.Paclitaxel: A cyclodecane isolated from the bark of the Pacific yew tree, TAXUS BREVIFOLIA. It stabilizes MICROTUBULES in their polymerized form leading to cell death.Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Camptothecin: An alkaloid isolated from the stem wood of the Chinese tree, Camptotheca acuminata. This compound selectively inhibits the nuclear enzyme DNA TOPOISOMERASES, TYPE I. Several semisynthetic analogs of camptothecin have demonstrated antitumor activity.Thrombocytopenia: A subnormal level of BLOOD PLATELETS.Maximum Tolerated Dose: The highest dose of a biologically active agent given during a chronic study that will not reduce longevity from effects other than carcinogenicity. (from Lewis Dictionary of Toxicology, 1st ed)Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Leukocyte Count: The number of WHITE BLOOD CELLS per unit volume in venous BLOOD. A differential leukocyte count measures the relative numbers of the different types of white cells.DeoxycytidineAntineoplastic Agents, Phytogenic: Agents obtained from higher plants that have demonstrable cytostatic or antineoplastic activity.Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.Antineoplastic Agents: Substances that inhibit or prevent the proliferation of NEOPLASMS.Felty Syndrome: A rare complication of rheumatoid arthritis with autoimmune NEUTROPENIA; and SPLENOMEGALY.Leukocyte Elastase: An enzyme that catalyzes the hydrolysis of proteins, including elastin. It cleaves preferentially bonds at the carboxyl side of Ala and Val, with greater specificity for Ala. EC 3.4.21.37.Fluorouracil: A pyrimidine analog that is an antineoplastic antimetabolite. It interferes with DNA synthesis by blocking the THYMIDYLATE SYNTHETASE conversion of deoxyuridylic acid to thymidylic acid.MycosesLeukopeniaVinblastine: Antitumor alkaloid isolated from Vinca rosea. (Merck, 11th ed.)Hematologic Diseases: Disorders of the blood and blood forming tissues.Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Receptors, Granulocyte Colony-Stimulating Factor: Receptors that bind and internalize GRANULOCYTE COLONY-STIMULATING FACTOR. Their MW is believed to be 150 kD. These receptors are found mainly on a subset of myelomonocytic cells.Carboplatin: An organoplatinum compound that possesses antineoplastic activity.Fever of Unknown Origin: Fever in which the etiology cannot be ascertained.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Encyclopedias as Topic: Works containing information articles on subjects in every field of knowledge, usually arranged in alphabetical order, or a similar work limited to a special field or subject. (From The ALA Glossary of Library and Information Science, 1983)Myelodysplastic Syndromes: Clonal hematopoietic stem cell disorders characterized by dysplasia in one or more hematopoietic cell lineages. They predominantly affect patients over 60, are considered preleukemic conditions, and have high probability of transformation into ACUTE MYELOID LEUKEMIA.Antifungal Agents: Substances that destroy fungi by suppressing their ability to grow or reproduce. They differ from FUNGICIDES, INDUSTRIAL because they defend against fungi present in human or animal tissues.Candidiasis, Invasive: An important nosocomial fungal infection with species of the genus CANDIDA, most frequently CANDIDA ALBICANS. Invasive candidiasis occurs when candidiasis goes beyond a superficial infection and manifests as CANDIDEMIA, deep tissue infection, or disseminated disease with deep organ involvement.TriazolesBlood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation.Platelet Count: The number of PLATELETS per unit volume in a sample of venous BLOOD.Purpura, Thrombocytopenic, Idiopathic: Thrombocytopenia occurring in the absence of toxic exposure or a disease associated with decreased platelets. It is mediated by immune mechanisms, in most cases IMMUNOGLOBULIN G autoantibodies which attach to platelets and subsequently undergo destruction by macrophages. The disease is seen in acute (affecting children) and chronic (adult) forms.Platelet Aggregation: The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS.Thrombopoietin: A humoral factor that stimulates the production of thrombocytes (BLOOD PLATELETS). Thrombopoietin stimulates the proliferation of bone marrow MEGAKARYOCYTES and their release of blood platelets. The process is called THROMBOPOIESIS.Receptors, Thrombopoietin: Cell surface receptors that are specific for THROMBOPOIETIN. They signal through interaction with JANUS KINASES such as JANUS KINASE 2.Pruritus: An intense itching sensation that produces the urge to rub or scratch the skin to obtain relief.Infusions, Subcutaneous: The administration of liquid medication or nutrients under the skin, usually over minutes or hours.Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes.Insulin, Short-Acting: Insulin derivatives and preparations that are designed to induce a rapid HYPOGLYCEMIC EFFECT.Phlebitis: Inflammation of a vein, often a vein in the leg. Phlebitis associated with a blood clot is called (THROMBOPHLEBITIS).Immunologic Deficiency Syndromes: Syndromes in which there is a deficiency or defect in the mechanisms of immunity, either cellular or humoral.Insulin Infusion Systems: Portable or implantable devices for infusion of insulin. Includes open-loop systems which may be patient-operated or controlled by a pre-set program and are designed for constant delivery of small quantities of insulin, increased during food ingestion, and closed-loop systems which deliver quantities of insulin automatically based on an electronic glucose sensor.

*Autoimmune neutropenia

In 80 percent of patients, neutropenia persisted for 7 to 24 months. Diagnosis Patients with autoimmune neutropenia are ... Consequently, patients with autoimmune neutropenia have low levels of granulocytic neutrophilic white blood cells causing a ... Autoimmune neutropenia is a form of neutropenia which is most common in infants and young children where the body identifies ... Primary autoimmune neutropenia (AIN) is an autoimmune disease first reported in 1975 that primarily occurs in infancy. In ...

*STAT3 GOF

Of the two patients treated by HCT, one patient died and the other was cured of autoimmune symptoms and improved growth. Larger ... Hematologic autoimmunity is most prevalent including autoimmune hemolytic anemia, neutropenia, and/or thrombocytopenia. Others ... One patient with severe autoimmune hemolytic anemia responded well to rituximab. Blocking IL-6 activation with tocilizumab in ... However, only 1 patient presented with large granular lymphocytic leukemia and 1 parent with Hodgkin lymphoma. The germline and ...

*RAS-associated autoimmune leukoproliferative disorder

... and neutropenia. Some patients have a history of recurrent respiratory tract infections. It is unclear if increased risk for ... The autoimmune phenotype can present in childhood or adulthood and primarily includes autoimmune hemolytic anemia, ITP, ... RALD patients show normal to modestly decreased total lymphocytes, mild to no elevation in αβ-double negative T cells, a ... RAS-associated autoimmune leukoproliferative disorder (RALD) is a rare genetic disorder of the immune system. RALD is ...

*Autoimmune lymphoproliferative syndrome

These include: Autoimmune hemolytic anemia, Autoimmune neutropenia, Autoimmune thrombocytopenia. Other signs can affect organ ... of patients). The liver is enlarged (hepatomegaly in 30 - 40% of patients). Autoimmune disease is the second most common ... Patients with ALPS have a defect in this apoptotic pathway, leading to chronic non-malignant lymphoproliferation, autoimmune ... 2% of patients ALPS-U: Undefined. 20% of patients CEDS: Caspase 8 deficiency state. No longer considered a subtype of ALPS but ...

*Large granular lymphocytic leukemia

... association with clonal chromosomal abnormalities and autoimmune neutropenia, thrombocytopenia, and hemolytic anemia". Ann. ... The 5 year survival has been noted as 89% in at least one study from France of 201 patients with T-LGL leukemia. T-LGLL is a ... Specimens from patients with LGLL are banked at the University of Virginia for research purposes, the only bank for such ... B symptoms are seen in a third of cases, and recurrent infections due to the associated neutropenia are seen in almost half of ...

*Neutropenia

... neutropenia, cyclic neutropenia, autoimmune neutropenia, and congenital neutropenia.[medical citation needed] Neutropenia that ... Observations of pediatric patients have noted that fungal infections are more likely to develop in patients with neutropenia. ... mother has autoimmune neutropenia Autoimmune neutropenia of infancy, the sensitization to self-antigens The pathophysiology of ... be effective in patients with congenital forms of neutropenia including severe congenital neutropenia and cyclic neutropenia, ...

*Chlorambucil

... 's current use is mainly in chronic lymphocytic leukemia, as it is well tolerated by most patients, though ... Moreover, it also has been used as an immunosuppressive drug for various autoimmune and inflammatory conditions, such as ... Bone marrow suppression (anemia, neutropenia, thrombocytopenia) is the most commonly occurring side effect of chlorambucil. ... chlorambucil has been largely replaced by fludarabine as first-line treatment in younger patients. It can be used for treating ...

*Terbinafine

... and neutropenia, autoimmune reactions such as lupus erythematosus Psychological problems: Depression, anxiety, insomnia, ... The tablets may, rarely, cause hepatotoxicity, so patients are warned of this and may be monitored with liver function tests. ... In 2015 physicians reported that a patient with an MTHFR enzyme mutation (specifically the C677T variant) had developed an ...

*Fludarabine

June 1998). "Severe autoimmune hemolytic anemia in eight patients treated with fludarabine". Hematol Cell Ther. 40: 113-8. PMID ... Fludarabine causes anemia, thrombocytopenia and neutropenia, requiring regular blood count monitoring. Some patients require ... Fludarabine is associated with the development of severe autoimmune hemolytic anemia in a proportion of patients. Difficulties ... For this reason, all patients who have ever received fludarabine should only be given irradiated blood components. ...

*Felty's syndrome

Most reports on treatment regimens involve small numbers of patients. Splenectomy may improve neutropenia in severe disease. ... A decrease in the number of neutrophils stimulates and autoimmune response which leads to arthritis. The loss and destruction ... Neutropenia In Felty's syndrome, chronic activation of neutrophils progresses to neutropenia and unabated infections. ... neutropenia). As a result of neutropenia, affected individuals are increasingly susceptible to certain infections. ...

*Sargramostim

It is also used to treat neutropenia induced by chemotherapy during the treatment of acute myeloid leukemia. Sargramostim has ... Sargramostim should not be used in patients with excessive leukemic myeloid blasts in the bone marrow or peripheral blood (≥ 10 ... This medication is being investigated in trials to treat autoimmune pulmonary alveolar proteinosis (PAP). It is also being ... "Wild-Type Reovirus in Combination With Sargramostim in Treating Younger Patients With High-Grade Recurrent or Refractory Brain ...

*X linked thrombocytopenia

X-linked congenital neutropenia can be diagnostically distinguished from XLT with persistent neutropenia, arrested development ... This same research showed that patients with XLT have a high overall survival rate but they are at risk for severe life- ... Males with X-linked thrombocytopenia are also susceptible to severe infections, bleeding, autoimmune diseases and malignancies ... Furthermore, research has shown that splenectomy may not be a good treatment option for patients with XLT as it increases the ...

*List of autoimmune diseases

"Inner ear autoantibodies and their targets in patients with autoimmune inner ear diseases". Acta Oto-Laryngologica. 12 (1): 28- ... FC Lafeber GJ, de Vries E, van Krieken JH, Cats A (1986). "Immune complexes and the pathogenesis of neutropenia in Felty's ... "Clinical implications of autoantibody screening in patients with autoimmune myositis". Autoimmunity. 39 (3): 217-221. doi: ... This list of autoimmune diseases is categorized by organ and tissue type to help locate diseases that may be similar. Overview ...

*Leukapheresis

The product is collected by automated apheresis and is used for systemic infections in patients with neutropenia. The donor is ... This is used as a treatment for autoimmune diseases such as ulcerative colitis and rheumatoid arthritis, where these cells play ... Leukapheresis may be performed to decrease a very high white blood cell count, to obtain autologous (i.e., the patient's own) ... Leukapheresis may also be performed to obtain the patient's own blood cells for later transplant. White blood cells may be ...

*Hematopoietic stem cell transplantation

... pediatric cases where the patient has an inborn defect such as severe combined immunodeficiency or congenital neutropenia with ... Immune deficiency syndromes Autoimmune diseases Many recipients of HSCTs are multiple myeloma or leukemia patients who would ... Bone pain receded post-donation to 26 percent of patients 2 days post-donation, 6 percent of patients one week post-donation, ... The question of whether geriatrics (patients over 65) react the same as patients under 65 has not been sufficiently examined. ...

*Kostmann syndrome

Isolated neutropenia in infants can occur in viral infections, autoimmune neutropenia of infancy, bone marrow suppression from ... Prevalence of mutations in ELANE, GFI1, HAX1, SBDS, WAS and G6PC3 in patients with severe congenital neutropenia. Br J Haematol ... Neutropenia Granulocyte colony-stimulating factor Klein, Christoph (2011). "Genetic Defects in Severe Congenital Neutropenia: ... Medicine Net Severe congenital neutropenia at NIH's Office of Rare Diseases Severe Chronic Neutropenia International Registry ...

*PSMD3

Lastly, autoimmune disease patients with SLE, Sjogren's syndrome and rheumatoid arthritis (RA) predominantly exhibit ... Furthermore, a genome-wide association study (GWAS) has identified that a variant in PSMD3 is associated to neutropenia induced ... inflammatory responses and autoimmune diseases, and systemic DNA damage responses leading to malignancies. Several experimental ... "Genome-wide association study identifies a PSMD3 variant associated with neutropenia in interferon-based therapy for chronic ...

*Cytokine

... used to treat neutropenia and fungal infections in cancer patients Interferon alfa, used to treat hepatitis C and multiple ... Dysregulation of this tendency is under intensive study for its possible role in the pathogenesis of autoimmune disorders. ... used to treat neutropenia in cancer patients Granulocyte macrophage colony-stimulating factor (GM-CSF), ... Interleukin 11 (IL-11), used to treat thrombocytopenia in cancer patients. Interferon gamma is used to treat chronic ...

*Primary immunodeficiency

Severe Congenital Neutropenia: due to ELA2 deficiency (with myelodysplasia) Severe Congenital Neutropenia: due to GFI1 ... UK Primary Immunodeficiency Patient Support Association (UKPIPS - UK Primary Immunodeficiency Patient Support Association) ... Others predispose to autoimmune disease, where the immune system attacks the body's own tissues, or tumours (sometimes specific ... Neutropenia with cardiac and urogenital malformations Glycogen storage disease type 1b Cyclic neutropenia X-linked neutropenia/ ...

*Cyclophosphamide

Neutropenia or lymphoma arising secondary to cyclophosphamide usage can predispose people to a variety of bacterial, fungal and ... Cyclophosphamide is used to treat cancers and autoimmune diseases. It is used to quickly control the disease. Due to its ... August 1995). "Effects of cyclophosphamide on the development of malignancy and on long-term survival of patients with ... Cyclophosphamide decreases the immune system's response, and although concerns about toxicity restrict its use to patients with ...

*Wiskott-Aldrich syndrome

Although autoimmune disease and malignancy may occur with both types of mutations, patients with truncated WASp carry a higher ... The rare disorder X-linked neutropenia has also been linked to a specific subset of WAS mutations. The protein product of WAS ... For severely low platelet counts, patients may require platelet transfusions or removal of the spleen. For patients with ... Not all patients have a positive family history of the disorder; new mutations do occur. Often, leukemia may be suspected on ...

*Regulatory T cell

... autoimmune thrombocytopenia, autoimmune neutropenia, and tubular nephropathy. The majority of affected males die within the ... CD8+ T suppressor cells predominate in patients with no protective immunity (visceral leishmaniasis patients). When added to ... autoimmune disease. The critical role regulatory T cells play within the immune system is evidenced by the severe autoimmune ... These Foxp3-expressing CD8+ T cells do not appear to be functional in healthy individuals but are induced in autoimmune disease ...

*Immunodeficiency

Hypomorphic RAG mutations are seen in patients with midline granulomatous disease; an autoimmune disorder that is commonly seen ... termed neutropenia). Granulocyte deficiencies also include decreased function of individual granulocytes, such as in chronic ... Wiskott-Aldrich syndrome (WAS) patients also present with eczema, autoimmune manifestations, recurrent bacterial infections and ... In addition to chronic and/or recurrent infections many autoimmune diseases including arthritis, autoimmune hemolytic anemia, ...

*Chloroquine

Patients on long-term chloroquine therapy should be screened at baseline and then annually after five years of use. The daily ... As it mildly suppresses the immune system, it is used in some autoimmune disorders, such as rheumatoid arthritis and lupus ... Pancytopenia, aplastic anemia, reversible agranulocytosis, low blood platlets, neutropenia. Chloroquine has not been shown to ... Patients should be screened for vision changes such as blurring of vision, difficulty focusing, or seeing half an object. ...

*Mouth ulcer

Ulcers and erosions can be the result of a spectrum of conditions including those causing auto-immune epithelial damage, damage ... Keogan MT (April 2009). "Clinical Immunology Review Series: an approach to the patient with recurrent orogenital ulceration, ... Hematological causes include anemia, hematinic deficiencies, neutropenia, hypereosinophilic syndrome, leukemia, myelodysplastic ... Numerous aphthous ulcers could be indicative of an inflammatory autoimmune disease called Behçet's disease. This can later ...
Chronic idiopathic neutropenia: Find the most comprehensive real-world symptom and treatment data on chronic idiopathic neutropenia at PatientsLikeMe. 10 patients with chronic idiopathic neutropenia experience fatigue, depressed mood, pain, anxious mood, and insomnia.
Autoimmune chronic active hepatitis is a chronic disease which results in inflammation of the liver. This disease majorly affects the middle aged women or young children and is related to HLA types A1, B8, DR3 and Dw3 and if the disease is not treated then it may cause liver cirrhosis. This disease affects one person out of 10,000 people where seven out of ten are usually women and women who are 45 years of age are affected by this disease. However it can affect all the age groups and children or elderly people as well.. Causes. The cause is still not clear of the condition but it is found that factors responsible for this condition are excess of alcohol, infections and viruses. It can be chronic which means that the condition will remain in for a long term. The chronic condition may result in destruction of liver causing serious issues. The autoimmune chronic active hepatitis occurs because the immune system triggers to attack the own ...
Autoimmune neutropenia is a form of neutropenia which is most common in infants and young children where the body identifies the neutrophils as enemies and makes antibody to destroy them. Primary autoimmune neutropenia (AIN) is an autoimmune disease first reported in 1975 that primarily occurs in infancy. In autoimmune neutropenia, the immune system produces autoantibodies directed against the neutrophilic protein antigens in white blood cells known as granulocytic neutrophils (granulocytes, segmented neutrophils, segs, polysegmented neutrophils, polys). These antibodies destroy granulocytic neutrophils. Consequently, patients with autoimmune neutropenia ...
Severe chronic neutropenia may be present at birth (congenital neutropenia) or may occur at any stage in life (acquired neutropenia). There are four main types of severe chronic neutropenia:. Congenital Neutropenia - a rare inherited form of the disease usually detected soon after birth. It affects children mainly and may result in premature loss of teeth and peremptory gum infections. The most severe form of chronic congenital neutropenia is known as Kostmanns Syndrome.. Cyclic Neutropenia - tends to occur every three weeks and lasting three to six days at a time due to changing rates of cell production by the bone marrow. It is often present among several members of the same family although improves after puberty in most cases. This is the rarest form of severe chronic ...
Once-daily dose administration of aminoglycoside in adults is effective and economical. However, its value in febrile neutropenic children, especially in Thailand, is less well researched. In the area where Pseudomonas aeruginosa prevalence in febrile neutropenic children is low, the combination of cloxacillin and amikacin is an appropriate approach. This study would like to compare the efficacy and safety including cost between these two amikacin administrations (once-daily or twice-daily) in combination with cloxacillin as an empirical therapy in febrile neutropenic children.. Hypothesis: Once-daily amikacin plus cloxacillin can be used to treat febrile neutropenic children in Khon Kaen, Thailand. ...
Local resource for autoimmune inner ear disease treatment in Grand Prairie, TX. Includes detailed information on local businesses that provide access to autoimmune inner ear disease treatment, tinnitus treatment, hearing loss treatment, and hearing aids, as well as advice and content on hearing loss, conditions of the ear, and hearing problems.
Local resource for autoimmune inner ear disease treatment in Naperville, IL. Includes detailed information on local businesses that provide access to autoimmune inner ear disease treatment, tinnitus treatment, hearing loss treatment, and hearing aids, as well as advice and content on hearing loss, conditions of the ear, and hearing problems.
Animal Auto-Immune Disease Diagnostics is used to check auto-immune diseases fo animals.Some of the popular animal auto-immune diseases are autoimmune hemolytic anemia, canine systemic lupus, and othe...
TY - JOUR. T1 - Pegfilgrastim for the prevention of chemotherapy-induced febrile neutropenia in patients with solid tumors. AU - Lambertini, Matteo. AU - Ferreira, Arlindo R.. AU - Del Mastro, Lucia. AU - Danesi, Romano. AU - Pronzato, Paolo. PY - 2015/10/22. Y1 - 2015/10/22. N2 - Introduction: Neutropenia and febrile neutropenia are the most common and most severe bone marrow toxicities of chemotherapy. Recombinant granulocyte-colony stimulating factors (G-CSFs), both daily (filgrastim and biosimilars, and lenograstim) and long-acting (pegfilgrastim and lipegfilgrastim) formulations, are currently available to counteract the negative consequences of these side effects. Areas covered: The purpose of this article is to review the physiopathology of chemotherapy-induced febrile neutropenia and its consequences, and the current evidence regarding the ...
We describe the first case of chronic neutropenia of 17 years duration following gold therapy in a 53-year-old woman given a 1-g course of gold therapy in 1965 for treatment of seropositive rheumatoid arthritis. Although she had a good response to the gold therapy, her originally normal leukocyte count fell to 1.2 x 10(9)/L. Over the subsequent 17 years, she required multiple hospitalizations for recurrent skin, mouth, and respiratory tract infections. Serial leukocyte counts failed to show a cyclical nature to the chronic neutropenia. Normal results of a technetium Tc 99m spleen scan and lack of increased bone marrow leukocyte precursors rendered a diagnosis of Feltys syndrome unlikely. A bone marrow biopsy specimen revealed an isolated reduction in the number of myeloid precursors, which is consistent with gold-induced bone marrow toxicity. This patients relative freedom from serious life-threatening infections remains enigmatic, but is ...
Genetic Heterogeneity of Severe Congenital Neutropenia Severe congenital neutropenia is a genetically heterogeneous disorder showing autosomal dominant, autosomal recessive, and X-linked inheritance. Autosomal dominant SCN2 ({613107}) is caused by mutation in the protooncogene GFI1 ({600871}) on chromosome 1p22. Autosomal recessive SCN3 ({610738}) is caused by mutation in the HAX1 gene ({605998}) on 1q21.3; autosomal recessive SCN4 ({612541}) is caused by mutation in the G6PC3 gene ({611045}) on 17q21; autosomal recessive SCN5 ({615285}) is caused by mutation in the VPS45 gene ({610035}) on 1q; autosomal recessive SCN6 ({616022}) is caused by mutation in the JAGN1 gene ({616012}) on 3p25; and autosomal recessive SCN7 ({617014}) is caused by mutation in the CSF3R gene ({138971}) on 1p34. X-linked SCN (SCNX; {300299}) is caused by mutation in the WAS gene ({300392}) on Xp11. For associations pending confirmation, see MOLECULAR GENETICS. See ...
CORVALLIS, Ore. - Scientists at Oregon State University have discovered a chemical compound that could be a safer alternative for treating autoimmune diseases.. Although studies in humans are still needed, the finding could bring hope to people suffering from conditions caused by their immune system attacking their bodies. Autoimmune diseases can affect almost any part of the body resulting in diseases such as colitis, multiple sclerosis and psoriasis.. "We mostly treat autoimmune diseases with high-dose corticosteroids or cytotoxic drugs to suppress the immune response, and the side effects can be very difficult to deal with," said lead researcher Nancy Kerkvliet. "But if this chemical works in clinical studies, it could result in a safer alternative to conventional drugs.". Kerkvliet collaborated with OSU professor Siva Kumar Kolluri and other colleagues who tested thousands of chemical compounds and found ...
as cyclical neutropenia and Grey Collie Syndrome, is an inherited blood disorder that results due to an autosomal dominant cell mutating. This disorder causes extremely low neutrophil blood levels in the body. Neutrophils are better known as white blood cells and they aid the body in fighting off infections. With this recurring condition, it approximately occurs every three weeks, while lasting anywhere from three to six days. When neutrophil level are low, the pet may be prone to more frequent infections. Symptoms of cyclic neutropenia are joint pain, diarrhea, skin infections, mouth ulcers, fevers, and frequent infections. Collie dog breeds tend to be the most common breed that suffers from this condition. Unfortunately there is no current cure available for pets who suffer from cyclic neutropenia, however, there are some medications your veterinarian can prescribe that may prolong your cat or dogs life by ...
Find the best chronic autoimmune neutropenia doctors in Gurgaon. Get guidance from medical experts to select chronic autoimmune neutropenia specialist in Gurgaon from trusted hospitals - credihealth.com
Study Objective: To determine whether recombinant human granulocyte colony-stimulating factor (G-CSF) is effective in increasing neutrophil counts in patients with hairy cell leukemia and neutropenia.. Design: Open label, phase I/II study of G-CSF, given by daily subcutaneous injection for up to 7 weeks.. Setting: Outpatient oncology clinic of a university medical center.. Patients: A consecutive sample of four patients with hairy cell leukemia complicated by severe neutropenia. Three patients completed the study; one patient was removed after 2 weeks of therapy.. Interventions: Granulocyte colony-stimulating factor was given by daily subcutaneous injection. Each patient began therapy with 1 µg/kg body weight ·d; after 1 week the dose was increased to 3 µg/kg ·d, and 1 week later to 6 µg/ kg ·d. Therapy was continued for 5 to 6 weeks. Patients were taught ...
Bolyard, Audrey, Pracht, G., Schwinzer, Beate, Zeidler, Cornelia, Bonilla, Mary Ann, Boxer, Laurence, Cham, Bonnie, Donadieu, J., Fier, Carol, Freedman, Melvin, Kannourakis, George, Kinsey, Sally, Winkelstein, J., Alter, Blanche, Reeves, L., Welte, Karl, Dale, David ...
Bolyard, Audrey, Pracht, G., Schwinzer, Beate, Zeidler, Cornelia, Bonilla, Mary Ann, Boxer, Laurence, Cham, Bonnie, Donadieu, J., Fier, Carol, Freedman, Melvin, Kannourakis, George, Kinsey, Sally, Winkelstein, J., Alter, Blanche, Reeves, L., Welte, Karl, Dale, David ...
Mannan Binding Lectin (MBL) is a member of the lectin pathway of the complement system and plays an important role in the innate immune system. MBL replacement in MBL-deficient children with chemotherapy-induced neutropenia represents a new approach to lower the risk of febrile episodes, of hospital admission, of prolonged use of intravenous antibiotics and of severe infections.. The aim of the Phase II study is to find evidence for the correct prediction of plasma levels of MBL necessary for clinical effects and biological efficacy, to confirm the dosage regimen needed to reach the required MBL plasma levels, and reconfirm the safety and lack of side-effects. ...
your doctor probably will give you a drug that helps with inflammation. high doses of steroids have been shown to work well for autoimmune inner ear disease, but they have many side effects.
Prednisone | Lupus | Auto-Immune Disease | Inflammation | Rheumatoid Arthritis When I was first diagnosed with Lupus, Rheumatoid Arthritis and MCTD or Mixed Connective Tissue Disease 16 years ago I was in a great deal of pain. It was difficult to simply get out of bed to go to the bathroom. The Rheumatologist prescribed daily…
Contact us and we will answer the inquiries and concerns you might have about Regenerative Medicine Institute of Nevada conventions for Auto-Immune Diseases.
Kostmann syndrome is a group of diseases that affect myelopoiesis, causing a congenital form of neutropenia (severe congenital neutropenia [SCN]), usually without other physical malformations. SCN manifests in infancy with life-threatening bacterial infections. Most cases of SCN respond to treatment with granulocyte colony-stimulating factor (filgrastim), which increases the neutrophil count and decreases the severity and frequency of infections. Although this treatment has significantly improved survival, people with SCN are at risk of long-term complications such as hematopoietic clonal disorders (myelodysplastic syndrome, acute myeloid leukemia). Kostmann disease (SCN3), the initial subtype recognized, was clinically described in 1956. This type has an autosomal recessive inheritance pattern, whereas the most common subtype of Kostmann syndrome, SCN1, shows autosomal dominant inheritance. Infants with SCN have frequent infections: 50% ...
TY - JOUR. T1 - Early hospital discharge of children with cancer treated for fever and neutropenia. T2 - Identification and management of the low-risk patient. AU - Mullen, Craig A.. AU - Buchanan, George R.. PY - 1990/1/1. Y1 - 1990/1/1. N2 - Children with leukemia and solid tumors are often hospitalized for empiric broad-spectrum antibiotic therapy because of fever during periods of chemotherapy-induced neutropenia. Conventional practice dictates that parenteral antibiotics be continued until the patient is afebrile and has recovered from neutropenia, ie, until the absolute neutrophil count (ANC) exceeds 500 cells per cubic millimeter. However, the practice in our center has been to discontinue parenteral antibiotic therapy and discharge many such patients before resolution of neutropenia. Since the feasibility and safety of this approach has not been ...
A new study from the University of Calgary could change the way researchers understand and treat autoimmune diseases such as type 1 diabetes, multiple sclerosis and rheumatoid arthritis. The study is published in the February edition of the prestigious journal Nature.
Objective: To assess the tolerance and efficacy of rituximab in patients with various autoimmune diseases seen in daily rheumatological practice. Methods: 866 rheumatology and internal medicine practitioners were contacted by email to obtain the files of patients treated with rituximab for systemic autoimmune diseases. Patients with lymphoma were analysed if the evolution of the autoimmune disease could be evaluated. Results: In all, 43 of 49 cases could be analysed, including 14 with rheumatoid arthritis (RA), 13 with systemic lupus erythematosus (SLE), six with primary Sjögrens syndrome (pSS), five with systemic vasculitis, and five with other autoimmune diseases. Rituximab was prescribed for lymphoma in two patients with RA and two with pSS. In the 39 other cases, rituximab was given because of the ...
TY - JOUR. T1 - Autoimmune neutropenia in multiple myeloma and the role of clonal t-cell expansion. T2 - Evidence of cross-talk between B-cell and T-cell lineages?. AU - Aryal, Madan Raj. AU - Bhatt, Vijaya Raj. AU - Tandra, Pavankumar. AU - Krishnamurthy, Jairam. AU - Yuan, Ji. AU - Greiner, Timothy C.. AU - Akhtari, Mojtaba. PY - 2014/2/1. Y1 - 2014/2/1. N2 - Autoimmune neutropenia (AIN), characterized by an absolute neutrophil count below 1500 cells/mL in the presence of autoantibodies directed against neutrophil antigens, can be secondary to a variety of underlying diseases, such as connective tissue diseases, infections, and malignancies. However, it has not been reported in association with multiple myeloma (MM). We report a case of AIN in a patient with MM who also had a population of small lymphocytes with T-cell receptor gamma chain gene rearrangements. We also ...
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TY - JOUR. T1 - Granulocyte colony-stimulating factor (G-GSF) prevents dose-limiting neutropenia in lymphoma patients receiving standard dose chemotherapy. AU - Dotti, G.. AU - Carlo Stella, C.. AU - Mangoni, L.. AU - Cottafavi, L.. AU - Caramatti, C.. AU - Almici, C.. AU - Rizzoli, V.. PY - 1995. Y1 - 1995. N2 - In this study, nine patients with non-Hodgkins lymphoma (n=6) and Hodgkins disease (n=3) receiving different cytotoxic chemotherapy regimens were given granulocyte colony-stimulating factor (C-CSF) (5 μg/kg/day) from 48 hours after the end of chemotherapy to 48 hours before the next chemotherapy administration. The decrease in mean absolute neutrophil counts (ANC) and in mean platelet (Plt) counts was not significant when pre-therapy counts were compared with posttherapy ones (p ,0.375 and p , 0.4, respectively). The mean actual dose intensity was 92% (range 68-100%). G-CSF treatment after chemotherapy reduces ...
During the period of neutropenia due to chemotherapy, patients have high risk of infections. The use of antibiotic prophylaxis to reduce neutropenia-related complications in oncologic patients is still disputed. Recent meta-analysis and clinical trials demonstrated that antibiotic prophylaxis with chinolons reduces fever episodes, bacterial infections and mortality in adult oncologic patients with neutropenia due to chemotherapy for acute leukaemia. In paediatric patients, the only randomized, double-blind, prospective study up till now suggested that Amoxicillin clavulanate may represent an effective prophylactic treatment to reduce fever and infections in oncologic children with neutropenia, with an efficacy statistically demonstrated only in patients with acute leukaemia. Considering the ...
Many autoimmune diseases are characterized by autoantibody reactivities to multiple cellular antigens. Autoantigens are commonly defined as targets of the autoimmune B cell response, but the role, if any, of these autoantigens in T cell-mediated autoimmune diseases is generally unknown. Murine experimental autoimmune gastritis is a CD4+ T cell-mediated organ-specific autoimmune disease induced by neonatal thymectomy of BALB/c mice. The murine disease is similar to human autoimmune gastritis and pernicious anemia, and is characterized by parietal and chief cell loss, submucosal mononuclear cell infiltrates, and autoantibodies to the alpha and beta subunits of the gastric H/K ATPase. However, the specificity of T cells that cause the disease is not known. To examine the role of the H/K ATPase in this T ...
Find the best cyclic neutropenia doctors in Kolkata. Get guidance from medical experts to select cyclic neutropenia specialist in Kolkata from trusted hospitals - credihealth.com
IF you answered yes to any of these questions, you may have an autoimmune disease, and this book is the "medicine" you need. Among the most prevalent forms of chronic illness in this country, autoimmune disease affects nearly 23.5 million Americans. This epidemic-a result of the toxins in our diet; exposure to chemicals, heavy metals, and antibiotics; and unprecedented stress levels-has caused millions to suffer from autoimmune conditions such as Graves disease, rheumatoid arthritis, Crohns disease, celiac disease, lupus, and more. In The Immune System Recovery Plan, Dr. Susan Blum, one of the most sought-after experts in the field of functional medicine, shares the four-step program she used to treat her own serious autoimmune condition and help countless patients reverse their symptoms, heal their immune systems, and prevent future illness ...
NE nurse Susan Alvarado says autoimmune diseases can be triggered by different events.. "Some are more genetic. Some are more environmental," she said. "Some are chemically induced.". Alvarado said it is important students let their campus nurse know about their condition and to let student accessibility resources know if they have special needs.. The more common autoimmune diseases are lupus, psoriasis, celiac disease and Type 1 diabetes. Over 80 different autoimmune diseases exist, and they affect the body differently.. For example, rheumatoid arthritis causes inflammation of the joints, and multiple sclerosis occurs when the immune system strips away the protective covering on nerves.. Some people can live regular lives while some remain sick and in debilitating pain.. Autoimmune diseases affect up to 50 million Americans, which is more than cancer and heart disease, ...
An autoimmune disease develops when your immune system, which defends your body against disease, decides your healthy cells are foreign invaders. As a result your immune system attacks healthy cells.. Psoriasis, arthritis, type 1 diabetes, chronic fatigue are all types of autoimmune disease (scroll down to see more). Depending on the type, an autoimmune disease can affect one or many different types of body tissue. It can affect all the organs, bones and cells: the skin, thyroid gland, pancreas, the joints, muscles and brain etc, it can also cause abnormal organ growth and changes organ function.. There are many types of autoimmune disease, many of which have similar symptoms, making diagnosis difficult. It is also possible to have more than one at the same time.. Autoimmune diseases usually fluctuate between periods of remission (where ...
TY - JOUR. T1 - Severe and Progressive Cellulitis Caused by Serratia marcescens Following a Dog Scratch. AU - Pithadia, Deeti J.. AU - Weathers, Erena N.. AU - Colombo, Rhonda E.. AU - Baer, Stephanie L.. PY - 2019/2/1. Y1 - 2019/2/1. N2 - Soft tissue infections occur in over 30% of patients with chemotherapy-induced neutropenia. Gram-positive bacterial infections predominate early in neutropenia, and likelihood of infection by resistant bacteria and fungi increases with prolonged neutropenia. Prior infections and exposures influence the risk of rare pathogens. A 55-year-old woman with chemotherapy-induced neutropenia was scratched on her forearm by a dog. She cleaned the wound with isopropanol and was treated empirically with amoxicillin-clavulanate. Over the next 4 days, she developed fever along with erythema, edema, and mild tenderness of the forearm ...
Generon, a Shanghai innovative biopharma, has forged a Special Protocol Assessment with the US FDA for the design of a second Phase III trial of its lead candidate. Gereron believes F-627 (benegrastim), a second-generation recombinant human granulocyte colony-stimulating factor dimer, has best-in-class potential to treat chemotherapy-induced neutropenia. The company is also testing a first-in-class recombinant human interleukin-22 as a treatment for graft-vs-host disease and acute alcoholic hepatitis.. Source: China Biotoday. ...
Five cases of severe neutropenia (neutrophil counts < 0.5 per 109 cells/L) associated with exposure to cocaine and levamisole, an antihelimithic agent no longer available in Canada, were identified in Alberta in 2008. Alberta and British Columbia (BC) public health officials issued an advisory and urged health care professionals to report cases to public health. This paper presents the findings of the public health investigations. Cases were identified prospectively through reporting by clinicians and a retrospective review of laboratory and medical examiners data from January 1, 2006 to March 31, 2009. Cases were categorized as confirmed, probable or suspect. Only the confirmed and probable cases are included in this paper. We compare cases of severe neutropenia associated with tainted cocaine (NATC) identified in Alberta and BC between January 1, 2008 to March 31, 2009. Of the 42 NATC cases: 23(55%) were from Alberta; 19(45%) were from ...
RUIZ DEL OLMO, Ignacio et al. Severe neutropenia as side effect of medical treatment in nontuberculous mycobacterial adenitis. Rev. chil. infectol. [online]. 2015, vol.32, n.5, pp.584-587. ISSN 0716-1018. http://dx.doi.org/10.4067/S0716-10182015000600016.. Non-tuberculous mycobacterial adenitis is getting more common in our environment. Epidemiologic studies and clinical trials published nowadays are limited. We present a 2-years-old boy diagnosed of Mycobacterium intracellulare adenitis and severe neutropenia as side effect of combined treatment with oral azythromycin and rifabutin, which recovers after suspending the second one. Liver metabolism of macrolide seems to increase other drugs toxicity, in this case, rifabutin. The patient eventually needed surgery due to persistence of the adenitis despite treatment with antibiotics.. Keywords : Adenitis; non-tuberculous mycobacteria; neutropenia; rifabutin. ...
A previous study explored factors discriminating colonization and true infection among non-transplant, non-neutropenic patients with repeated Aspergillus spp. isolation from lower respiratory samples. The present study explored the evolution of patients with Aspergillus colonization in that study to determine the percentage of cases progressing to aspergillosis and time to development. Clinical records were retrospectively reviewed (for each patient from his end date in the past study) and data from all respiratory processes suffered by patients up to April 2015 were recorded. Comparisons of variables were performed between colonized patients that developed aspergillosis and those that did not. A Kaplan-Meier curve was used to describe time to development of aspergillosis in chronic obstructive pulmonary disease (COPD) patients for II-IV stages of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) ...
Background. The 2008 WHO classification identified refractory cytopenia with unilineage dysplasia (RCUD) as a composite entity encompassing refractory anemia, refractory thrombocytopenia (RT), and refractory neutropenia (RN), characterized by 10% or more dysplastic cells in the bone marrow respective lineage. The diagnosis of RT and RN is complicated by several factors. Diagnosing RT first requires exclusion of familial thrombocytopenia, chronic auto-immune thrombocytopenia, concomitant medications, viral infections, or hypersplenism. Diagnosis of RN should also be made after ruling out differential diagnoses such as ethnic or familial neutropenia, as well as acquired, drug-induced, infection-related or malignancy-related neutropenia. An accurate quantification of dysplasia should be performed in order to distinguish RT or RN from the provisional entity named idiopathic cytopenia of unknown significance ...
The mortality rate at eight weeks was similar in the lenograstim and placebo groups (23 and 27 percent, respectively; P = 0.60), as was the incidence of severe infections. The median duration of neutropenia (absolute neutrophil count , or = 1000 per cubic millimeter) was shorter in the lenograstim group (21 days, as compared with 27 days in the placebo group; P , 0.001). Eight percent of the patients in both groups had regrowth of AML cells. The rate of complete remission was significantly higher in the lenograstim group (70 percent, as compared with 47 percent in the placebo group; P = 0.002). Overall survival, however, was similar in the two groups (P = 0.76). Conclusions: ...
Suppression of the haematopoietic system, especially of the myeloid lineage, is a severe complication of systemic lupus erythematosus (SLE).1 In a recent report Euler et al suggested rhG-CSF as an effective treatment of neutropenia during SLE, especially during infection resistant to antibiotic treatment.2 We present a case of a girl with SLE whose neutropenia did not respond to rhG-CSF and who subsequently succumbed to untreatable fungal sepsis.. A previously healthy 9.5 year old girl developed SLE presenting with six of 11 criteria of the American College of Rheumatology including butterfly rash, oral ulcers, arthritis, and serositis. Laboratory investigations demonstrated ANA+, anti-dsDNA+, hypocomplementaemia, but normal white blood cell count. Eight months after initial remission she had a relapse, presenting with neutropenia (650 neutrophils/μl, 800 lymphocytes/μl) and signs of nephritis. Bone marrow ...
Neutropenic enterocolitis is a life-threatening, necrotizing enterocolitis occurring primarily in neutropenic patients. Other terms that have been used to describe this syndrome include necrotizing enterocolitis and ileocecal syndrome. Neutropenic en
We report herein an incidence of SCN in Sweden of 1·0 per 100 000 live births, including patients with verified disease-causing mutations and patients with probable SCN. On average one child per year in Sweden has been diagnosed with SCN. Previously, the prevalence of SCN has been estimated to 1-2 patients per million inhabitants with equal gender distribution (Zeidler et al, 2009). This estimate implies that Sweden, with a population of about 9 million inhabitants, would have 9-18 patients currently alive with SCN. In fact, our study identified 21 patients born during a period of 20 years, and of these, 18 patients are currently alive corresponding to a minimal prevalence of two patients per million inhabitants. However, the current study does not provide information on patients alive and born prior to 1987, who would have contributed to even higher prevalence figures.. The ...
Granulocyte colony-stimulating factor (G-CSF) has been utilized to treat neutropenia in various clinical settings. Although clearly beneficial, there are concerns that the chronic use of G-CSF in certain conditions increases the risk of myelodysplastic syndrome (MDS) and/or acute myeloid leukemia (AML). The most striking example is in severe congenital neutropenia (SCN). SCN patients develop MDS/AML at a high rate that is directly correlated to the cumulative lifetime dosage of G-CSF. MDS and AML that arise in these settings are commonly associated with chromosomal deletions. We have demonstrated in this study that chronic G-CSF treatment in mice results in expansion of the hematopoietic stem cell population. In addition, primitive hematopoietic progenitors from G-CSF-treated mice show evidence of DNA damage as demonstrated by an increase in double strand breaks and recurrent chromosomal deletions. Concurrent treatment with ...
TY - JOUR. T1 - MSG-10. T2 - a Phase 2 study of oral ibrexafungerp (SCY-078) following initial echinocandin therapy in non-neutropenic patients with invasive candidiasis. AU - Mycoses Study Group AU - Spec, Andrej. AU - Pullman, John. AU - Thompson, George Richard. AU - Powderly, William G.. AU - Tobin, Ellis H.. AU - Vazquez, Jose. AU - Wring, Stephen A.. AU - Angulo, David. AU - Helou, Silvia. AU - Pappas, Peter G.. PY - 2019/10/1. Y1 - 2019/10/1. N2 - OBJECTIVES: To evaluate the safety and efficacy of two dosing regimens of oral ibrexafungerp (formerly SCY-078), a novel orally bioavailable β-glucan synthase inhibitor, in subjects with invasive candidiasis versus the standard of care (SOC) and to identify the dose to achieve target exposure (15.4 μM·h) in ,80% of the intended population. METHODS: In a multinational, open-label study, patients with documented invasive candidiasis were randomized to receive step-down therapy to one of three treatment arms: two dosing ...
Initial evaluation of patients with febrile neutropenia includes a thorough history and physical examination; a complete blood cell count; measurement of serum creatinine, blood urea nitrogen, transaminases, and C-reactive protein; and culture of blood (samples from a peripheral vein and/or catheter). Chest radiography is indicated for patients with respiratory signs or symptoms. Signs and symptoms of inflammation may be minimal or absent. However, a search should be undertaken in the sites most commonly infected, including the periodontium, pharynx, lower esophagus, lung, perineum, eyes, and skin. Blood samples, including samples from catheter lumen(s), if present, and a peripheral vein, should be obtained for cultures for bacteria and fungi. Urine culture is indicated in the presence of signs or symptoms of urinary tract infection, a urinary catheter in place, or abnormal results of urinalysis. Fever is defined as a single axillary ...
There are no randomized controlled trials proving the clinical benefit of granulocyte transfusions. However, clinical experience and a number of case studies suggest that granulocyte transfusions may be life-saving in certain situations. In our opinion granulocyte transfusions should be considered for patients with profound neutropenia and severe, life-threatening infection not responding to antibiotic or antifungal therapy. Since the clinical effect seems to be dose-dependent, the granulocyte concentrate should contain a large number of cells, which usually means that the donor should be mobilized with steroids and G-CSF. Regular blood donors as well as relatives to the patient can be used for granulocyte donations with apheresis technique after information of the process. Granulocyte transfusion should be given daily as long as the indication remains. The clinical efficacy of the transfusions should be evaluated daily.. ...
The causes and mechanisms of late-onset neutropenia (LON) following rituximab treatment in patients with rheumatic diseases are not known. In this study, we aimed to investigate the role of established Fcγ receptor gene (FCGR) polymorphisms and B-cell-activating factor (BAFF) gene promoter polymorphisms for the development of LON and for the efficacy of rituximab in patients with rheumatic diseases. A single-center case-control retrospective study was nested in a cohort of 214 consecutive patients with rheumatic diseases treated with rituximab. Eleven patients presented with LON. Fifty non-LON control subjects were matched by diagnosis, age, sex, and treatments. Single-nucleotide polymorphisms of FCGR (FCGR2A 131H/R, FCGR2B 232I/T, FCGR3A 158V/F) and BAFF promoter polymorphism −871C/T were analyzed with polymerase chain reaction-based techniques, and serum immunoglobulin M (IgM) and BAFF levels were analyzed ...
Neutrophil granulocytes: Low neutrophil (neutropenia) and high neutrophil level counts on blood tests: Easy to understand entry on this type of white blood cell (Lymphocytes B cells and T cells; Monocytes; Eosinophils; Basophils).
SkyePharma is developing a formulation of granulocyte colony-stimulating factor (GCSF) for the prevention and treatment of chemotherapy-induced neutropenia.The
Bioassay of Recombinant Human Granulocyte Colony Stimulating Factor (rhG-CSF) for Neutropenia Treatment in Male Sprague Dawley Rats
TY - JOUR. T1 - Comparative efficacy and safety of interventions for preventing chemotherapy-induced oral mucositis in adult cancer patients. T2 - A systematic review and network meta-analysis. AU - Wilairat, Preyanate. AU - Kengkla, Kirati. AU - Kaewpanan, Thanatchai. AU - Kaewthong, Jirapat. AU - Ruankon, Sorave. AU - Subthaweesin, Chulalak. AU - Stenehjem, David D.. AU - Saokaew, Surasak. PY - 2020/3/1. Y1 - 2020/3/1. N2 - Objective: To examine the comparative efficacy and safety of interventions for preventing chemotherapy-induced oral mucositis (OM) in adult cancer patients. Methods: We searched PubMed, Embase and the Cochrane Central systematically for the randomised control trials (RCTs) of interventions for preventing OM. Network meta-analysis (NMA) was performed to estimate risk ratios (RR) and 95% confidence intervals (CI) from both direct and indirect evidence. The primary outcome was any grade of OM. Secondary outcomes were mild-moderate OM, severe OM and adverse ...
OBJECTIVES: To estimate the cord blood levels of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) in preterm infants and to study the relationship of these levels to pregnancy-induced hypertension (PIH) and absolute neutrophil counts.. STUDY DESIGN: G-CSF and GM-CSF levels in the cord blood of preterm neonates (n = 74) either with or without maternal PIH were estimated by enzyme-linked immunosorbent assay.. RESULTS: Infants in the PIH group had lower white blood cell, absolute neutrophil, absolute lymphocyte, and monocyte counts. The levels of G-CSF in cord blood were significantly lower in infants whose mothers had PIH (P =.04) and in infants with neutropenia (P =. 01). G-CSF levels were positively correlated with both absolute neutrophil count (P =.02) and total white blood cell count (P =.01). GM-CSF was undetectable in all subjects. According to logistic regression with ...
Learn more about Neutropenia at Atlanta Outpatient Surgery Center DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
Clozapine is known as one of the atypical antipsychotics which is placed in the second line of medical treatment for schizophrenia due to its hematologic complications. It is used in cases of resistance to treatment. Some side effects of clozapine include leukopenia, granulocytopenia, fever, hepatotoxicity, sedation, dizziness, hypotension, weight gain, constipation, and seizure. Neutropenia and hepatotoxicity have been separately reported after taking atypical antipsychotics, including clozapine. However, simultaneous occurrence of these two complications is rare and has not been reported with clozapine use. This study reports a case of concurrent hepatotoxicity and neutropenia induced by clozapine. The patient was a 58-year-old man who started taking clozapine for the first time in March 2017, about seven weeks before his recent admission, because of a history of treatment-resistant schizophrenia. He had been referred to the emergency ...
Neutropenic enterocolitis (NE) historically primarily affects pediatric patients with leukemia who are undergoing chemotherapy or who have recently received bone marrow transplants. Although a few case reports have shown NE occurring outside of this typical population, to our knowledge, this is the …
Lege og forsker Dag Torfoss har i sin avhandling Penicillin G plus an aminoglycoside in febrile neutropenia oppsummert studier med penicillin og aminoglykosid ved feber etter cellegiftbehandling. Alle studiene viser at penicillin og aminoglykosid er effektiv og sikker tidlig behandling til disse pasientene. Videre har han og hans medarbeidere gjennomført en klinisk undersøkelse med 174 pasienter der han viser at aminoglykosid gitt en gang i døgnet er like effektiv som tre ganger i døgnet. Dette har forenklet behandling med penicillin og aminoglykosid. Til slutt viser han at ingen laboratorieprøver er bedre enn regelmessig klinisk undersøkelse av pasienter med feber etter cellegiftbehandling for å fange opp komplikasjoner til behandlingen ...
Success rate and risk factors for failure of empirical antifungal therapy with itraconazole in patients with hematological malignancies: a multicenter, prospective, open-label, observational study in Korea. ...
0196] Throughout this application, various publications are referenced, specifically including those listed below. All such references are incorporated herein by reference. [0197] Brajtburg, J., W. G. Powderly, G. S. Kobayashi and G. Medoff. 1990. Amphotericin B: current understanding of mechanisms of action. Antimicrob Agents Chemother. 34:183-188. [0198] Cagnoni, P. J., T. J. Walsh, M. M. Prendergast, D. Bodensteiner, S. Hiemenz, R. N. Greenberg, C. A. Arndt, M. Schuster, N. Seibel, V. Yeldandi, and K. B. Tong. 2000. Pharmacoeconomic analysis of liposomal amphotericin B versus conventional amphotericin B in the empirical treatment of persistently febrile neutropenic patients. J. Clin. Oncol. 18(12):2476-83. [0199] Chavanet, P., V. Joly, D. Rigaud, J. Bolard, C. Carbon, P. Yeni. Influence of diet on experimental toxicity of amphotericin B deoxycholate. Antimicrob. Agents Chemother. 1994;38(5):963-8. [0200] Cleary, J. D., R. L. Nolan, and S. W. Chapman. 1992 Inhibition of interleukin 1 ...
To the editor: In a recent article, Winston and associates (1) presented data that led them to conclude that therapeutic granulocyte transfusions offered no substantial benefit over optimal antimicrobial therapy alone in managing infected patients with granulocytopenia. We have difficulty extrapolating their observations to granulocyte transfusion therapy as given at our institution (2) and others (3) where doses of three to six times as many granulocytes are administered routinely. The authors have criticized other randomized trials of granulocyte transfusions in neutropenic patients for having too few patients. We find the major weakness of this study to be too few granulocytes ...
Wiskott-Aldrich syndrome (WAS; MIM 301000) is an X-linked recessive disorder associated with combined immunodeficiency, thrombocytopenia, eczema, recurrent infections and increased susceptibility for malignancies and autoimmune disorders. Wiskott-Aldrich syndrome is caused by mutations in the WAS gene, which encodes Wiskott-Aldrich syndrome protein. Mutations in the WAS gene can also cause thrombocytopenia 1 (THC1; MIM 313900) and neutropenia, severe congenital, X-linked (SCNX; MIM 300299). THC1 and SCNX are clinically milder than Wiskott-Aldrich syndrome. THC1 is nonsyndromic thrombocytopenia characterized by decreased numbers of platelets and bleeding tendency. Patients with SCNX have severe congenital neutropenia, low to low-normal platelet count and normal mean platelet volume.. Read less ...
BACKGROUND: We aimed to define the maximum tolerated dose (MTD) and characterize the toxicity of the combination of pegylated liposomal doxorubicin (PLD; Caelyx trade mark ) and weekly paclitaxel (wPTX), and to investigate pharmacokinetics of PLD in this combination. METHODS: A phase I study was performed with an initial dose of 50 mg/m(2) wPTX and 30 mg/m(2) PLD. The paclitaxel dose was escalated in increments of 10 mg/m(2) and PLD in increments of 5 mg/m(2) until the MTD was reached. The pharmacokinetics of PLD were studied at the highest achieved dose levels. RESULTS: Forty-four cancer patients were enrolled. The MTD was 30/90 and 35/80 mg/m(2) for PLD/wPTX. Dose-limiting toxicities included treatment delay for neutropenia grade 3, febrile neutropenia, palmar-plantar erythrodysesthesia and deep venous thrombosis. Toxicity below the MTD was mild: skin toxicity grade 1-2 developed at high cumulative doses and vascular ...
Myelo Therapeutics announced that it has raised an undisclosed amount of Series B funding. The financing round was co-led by venture capital investors IBB Beteiligungsgesellschaft mbH with its VC Fonds Technologie Berlin and Eckert Life Science Accelerator GmbH, as well as the pharmaceutical company JSC Valenta Pharmaceuticals and Myelo001 inventor Dr. Vladimir Nebolsin. The successful closing of its Series B financing round will enable Myelo Therapeutics to complete the clinical proof of concept for Myelo001 in CIN and expand its preclinical research of Myelo001 to new areas.. Dirk Pleimes, Managing Director and Chief Medical Officer, stated, "Myelo001 offers a novel, orally applied treatment of chemotherapy-induced neutropenia and bone marrow suppression. New adjunct treatment options are needed for cancer patients to allow the full chemotherapy dose to be maintained and to decrease the incidence of infections. " Till Erdmann, Managing Director responsible ...
Looking for granulocyte transfusion? Find out information about granulocyte transfusion. the injection of blood, blood plasma, etc., into the blood vessels of a patient The administration of blood, or one of its components, as a part of treatment Explanation of granulocyte transfusion
Feltys syndrome is a rare, potentially serious disorder that is defined by the presence of three conditions: rheumatoid arthritis (RA), an enlarged spleen (splenomegaly) and a decreased white blood cell count (neutropenia), which causes repeated infections. Although some individuals with Feltys syndrome are asymptomatic, others can develop serious and life-threatening infections. Symptoms of Feltys syndrome, in addition to those associated with the three conditions stated above, may include fatigue, fever, weight loss, discoloration of patches of skin, mild hepatomegaly (enlarged liver), lymphadenopathy (swelling of lymph nodes), Sjšgren syndrome, vasculitis, lower-extremity ulcers, and other findings. The exact cause is unknown, but several risk factors have been proposed, including autoimmunity. A few familial cases of the condition have been reported. Treatment typically focuses on controlling the underlying RA; immunosuppressive therapy for RA may improve ...
Amphotericin B lipid soluble formulations versus amphotericin B in cancer patients with neutropenia Stable (no update expected for reasons given in Whats new) answers are found in the Cochrane Abstracts powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.
Evidence-based preventative strategies include cryotherapy, low-level light therapy and keratinocyte growth factor. However, these strategies are often not available in resource-poor settings. There is some evidence that honey may be a suitable treatment for OM in adult patients. We performed a literature search of 11 databases to find papers exploring the use of honey to treat chemotherapy-associated mucositis in paediatric oncology patients ...
Case description: A 59 year old female with acute myeloid leukemia M7 variant presented with one week of progressive facial, head, and neck lesions preceded by a small right thigh macular lesion that had developed into a larger papulo-pustular lesion. Subsequently, a number of similar papular lesions erupted across her forehead and grew into painful nodulo-pustular lesions. Associated right sided periorbital edema prompted her hospitalization. She has a history of recurrent upper respiratory infections, pulmonary aspergillosis, staphylococcus epidermidis vertebral osteomyelitis, diabetes mellitus, and genital herpes. For AML, she had received two remission induction cycles of idarubicin/cytarabine, then high dose ara-C five months prior to admission. For persistent neutropenia, she required daily granulocyte-colony stimulating factor. Other medications included carvedilol, lisinopril, gabapentin, lorazepam, oxycodone, and valacyclovir. Admission vital signs were ...
Vitamins B6 and B12 as well as folic acid are all responsible for producing WBCs in the body.. A 2011 study published in the Journal of Medical Case Reports notes that a neutropenia patient reported significantly decreased levels of vitamins B6, B12 and folic acid. Oral vitamin B6 supplementation increased the level of neutrophil WBCs and corrected her condition.. Severe neutropenia can cause cancer. The study further suggests a thorough screening for deficiencies of vitamins B6, B12 and folic acid in neutropenia patients for focused treatment.. Foods rich in vitamin B6 include sunflower seeds, turkey, chicken, dried nuts, avocados, bananas and spinach.. Foods rich in vitamin B12 include fortified breakfast cereals, low-fat milk and yogurt, chicken, clams, salmon and trout.. Foods rich in folic acid include dried beans and peas; lentils; leafy greens like broccoli, spinach, okra and ...
Anthroposophic Medicine | Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletow Extract to Chemotherapy Alone by Wilfried Troeger et al
Endosomal trafficking and autophagy are two fundamental processes of eukaryotic cell biology, from unicellular organisms such as yeast to multicellular metazoans such as C.elegans and Humans. Both processes are involved in a diverse number of physiological processes and implicated in a number of pathologies. A recent study has exhibited a mutation on the SM protein Vps45 as a cause of severe congenital neutropenia in humans. The same mutation in yeast causes defects in endosome to vacuole trafficking in S.cerevisiae as well as a temperature sensitive lethality at the non-permissive temperature. A null allele of vps-45 in C.elegans results in developmental arrest during the highly secretory phase of moulting in a similar temperature conditional manner to yeast and defects in yolk protein trafficking. The work presented in this thesis aims to provide basic understanding in an animal model of the impact of loss of Vps45 function that might be informative of the reason for the ...
RATIONALE: Recombinant human mannose-binding lectin (MBL) may be effective in preventing infection in young patients with fever and neutropenia receivin
The European Medicines Agency (EMA) has accepted an application to review Sandozs biosimilar to Amgens EU-licensed Neulasta (pegfilgrastim), a recombinant human granulocyte colony-stimulating factor, Sandoz parent Novartis said on Thursday.
article{df027303-d823-4a01-840a-7bebb6a9e463, author = {Ivarsson, Sten A. and Ljung, Rolf}, issn = {0891-3668}, language = {eng}, number = {6}, pages = {436--437}, publisher = {Lippincott Williams & Wilkins}, series = {Pediatric Infectious Disease Journal}, title = {Neutropenia and congenital cytomegalovirus infection}, volume = {7}, year = {1988 ...
Abraham, I., MacDonald, K., Song, M.K., Ciesielski, G., Pacheco, C., Lee, C., Cholette, M., Kinsey, K., Speaks, P., Hermans, C., Brié, H., Reel, S., Van der Niepen, P., Yee, B., & Vancayzeele, S. (in press). Patient- and physician-level determinants of blood pressure response to treatment in normal and overweight patients. (the PREVIEW Study). Nutrition, Metabolism, & Cardiovascular Diseases.. Aapro, M., Cornes, P., & Abraham, I. (in press). Comparative cost-efficiency across the European G5 countries of various regimens of filgrastim, biosimilar filgrastim, and pegfilgrastim to reduce the incidence of chemotherapy-induced febrile neutropenia. Journal of Oncology Pharmacy Practice.. Gesualdo, L., London, G., Turner, M., Lee, C., MacDonald, K., Covic, A., Zaoui, P., Combe, C., Dellana, F., Muenzberg, M., & Abraham, I. (in press). A pharmacoepidemiological study of the multi-level determinants, predictors, and clinical outcomes of biosimilar epoetin alfa for ...
We have previously reported on bilateral intra-arterial (IA) chemosurgery for bilateral retinoblastoma, or tandem therapy.1 While this allows both eyes to be treated during the same IA session, it also exposes the patient to twice the dose of chemotherapy (typically melphalan and topotecan). Even at the doses used for IA, the systemic levels of melphalan can be dose-limiting (melphalan may induce neutropenia at doses higher than 0.4 mg/kg). To obviate the need for melphalan dose restriction during tandem therapy, we report on the use of single agent carboplatin to the fellow eye. ...
3 Indications Requested in the NDA Treatment of invasive aspergillosis Empiric antifungal therapy of febrile neutropenic patients Treatment of: -candida esophagitis -serious candida infections -serious fungal infections due to Fusarium and Scedosporium spp. -serious fungal infections in patients refractory or intolerant to other therapy
Clinical data regarding the use of colony-stimulating factors for the treatment of acute myeloid leukemia (AML) are conflicting because of varying study conditions. Interpretation of data is affected by differences in patients ages, induction regimens, the timing of growth factor administration, the presence of marrow hypoplasia, disease states, differences in the products used, and statistical endpoints. Most trials of granulocyte colony-stimulating factor (G-CSF) and yeast-derived granulocyte- macrophage colony-stimulating factor (GM-CSF) have demonstrated a significant shortening of neutrophil recovery time and a trend toward higher rates of complete remission. Several studies have demonstrated a significant reduction in the rates of morbidity or early mortality with G-CSF or GM-CSF. In vitro data support the concept of enhancing antimicrobial activity with macrophage colony-stimulating factor or GM-CSF. The safety and potential benefit of these cytokines suggest that cytokines should be ...
Despite sporadic reports implicating various Candida species as the cause of candidemia associated with the use of CVC or TPN (2, 15, 23; Rex, Editorial Response), few studies have examined biofilm production among Candida species isolates derived from the blood and compared these results to those obtained for isolates from other anatomical sites. Also, few studies have examined the relationship between biofilm production by bloodstream isolates and clinically significant disease. To our knowledge, we are the first to examine and compare such associations.. In this study, we used SDB medium that contained high glucose (8%) and protein (1%), which has been used to induce biofilm formation by C. parapsilosis isolates in several studies (3, 10, 19). Although SDB is not a defined medium, it is more similar to the milieu found in vivo (especially within the CVC lumen) of patients receiving TPN via CVC. TPN solutions usually contain high glucose (10 to 70%) and amino acid (up to 50%) ...
Objectives: To determine the influence of family, peers, school, and physicians on exercise in pediatric oncology patients and evaluate the barriers to physical activity levels in this population. Methods: A search of PubMed and Google Scholar resulted in 12 related articles. The articles were assessed for the influence of school systems, family, peers, self-efficacy, and physicians on exercise. Additionally barriers and interventions to physical activity were also assessed. Limitations and research methodologies of each article were also evaluated. Results: Many school systems were unsure of expectations in regards to physical activity for their returning students with cancer. Most schools acknowledged willingness to increase exercise for these students; however, there is a communication gap between the medical field and the school system on what expectations should be. Family is associated with increased physical activity levels and healthier diets in this population with children ...
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Hematologic toxicity: Severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow depression, and aplastic anemia have occurred with the use of Valcyte or ganciclovir. Avoid Valcyte use if absolute neutrophil count is less than 500 cells/µL, platelet count is less than 25,000/µL, or hemoglobin is less than 8 g/dL. Use with caution in pre-existing cytopenias and when receiving myelosuppressive drugs or irradiation. Monitor with frequent testing of platelet and complete blood counts. In patients with severe leukopenia, neutropenia, anemia and/or thrombocytopenia, treatment with hematopoietic growth factors and or the interruption of therapy is recommended. Patients with low baseline platelet counts ...
Management of infusion reactions to systemic anticancer therapy • Management of toxicities from immunotherapy • Management of febrile neutropaenia • MASCC and ESMO consensus guidelines for the prevention of chemotherapy and radiotherapy-induced nausea and vomiting • Treatment of dyspnoea in advanced cancer patients • Central venous access in oncology • Management of oral and gastrointestinal mucosal injury • Management of refractory symptoms at the end of life and the use of palliative sedation • Advanced care planning in palliative care • Bone health in cancer patients • Cancer, fertility and pregnancy • Management of chemotherapy extravasation • Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy • Management of cancer pain • Management of venous thromboembolism in cancer patients • Prevention of chemotherapy and radiotherapy-induced nausea • Erythropoiesis-stimulating agents in the treatment of anaemia in cancer ...
Purpose: The purpose was to investigate the presence of hypercoagulability in the very early phase of the host response to an infection in the clinical course of sepsis and septic shock. Material and Methods: Twenty-four patients with chemotherapy-associated febrile neutropenia were evaluated at baseline, at the time of fever onset, and 48 hours thereafter using the thrombin generation test, a more physiological and global assay of hemostasis. Results: The rate of thrombin generation was decreased and no signals of systemic hypercoagulability could be observed during the first 48 hours of sepsis. Moreover, patients that evolved to septic shock presented a more significant impairment in thrombin generation than those with noncomplicated sepsis. Conclusions: Patients with sepsis and febrile neutropenia present an impairment in thrombin generation from very early stages of their disease course. ...
This study shows that neutrophils are critical for combating experimental systemic infections of mice by the bacterial pathogens Listeria monocytogenes, Salmonella typhimurium, and Yersinia enterocolitica. It shows that mice rendered neutropenic by treatment with the granulocyte-depleting monoclonal antibody RB6-8C5 are far more susceptible than immunocompetent mice to infection with each of these three pathogens. Compared to immunocompetent mice, neutropenic mice exhibit several defects in their antibacterial capabilities. Firstly, the immediate inactivation of Listeria, Salmonella, or Yersinia that initially implants in the livers and spleens that occurs in immunocompetent mice is abolished in these organs in neutropenic mice. Secondly, unlike immunocompetent mice, neutropenic mice neither control the subsequent proliferation of the inoculated bacteria in the livers and spleens nor prevent dissemination of infection to other organs. Thirdly, mice rendered neutropenic develop a generalized ...
SAN ANTONIO-Targeted support with G-CSF (filgrastim, Neupogen) based on cycle 1 ANC (absolute neutrophil count) nadirs improves the delivery of planned-dose-on-time chemotherapy and significantly reduces the incidence of febrile neutropenia and related hospitalizations, according to study from The University of Texas M.D. Anderson Cancer Center study using a prospective risk model. Edgardo Rivera, MD, assistant professor of breast medical oncology, presented the results at the 24th San Antonio Breast Cancer Symposium (abstract 3). 1
Non-glycosylated, recombinant human granulocyte colony-stimulating factor (rhG-CSF), produced by Escherichia coli(filgrastim, leukostim) is widely used to treat a number of serious human diseases...
Objective: To observe the efficacy and safety between Pegfilgrastim (PEG-rhG-CSF) and Recombinant human granulocyte colony stimulating factor (rhG-CSF) in hematological malignancy after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: 157 patients after allo-HSCT were enrolled in this study from June 2015 to November 2016. Two agents of G-CSF were used to stimulate hematopoietic recovery after transplantation. There were 65 cases in PEG-rhG-CSF and 92 cases in rhG-CSF groups. Patients in PEG-rhG-CSF group were given a single subcutaneous dose of 6 mg on the first day and +8 d, while cases in rhG-CSF group were given in dose of 5 μg·kg(-1)·d(-1) by subcutaneous injection from +1 d continuing to neutrophils more than 1 ...
Background. Prognosis of acute lymphoblastic leukemia in elderly is poor. The GRAALL-SA1 phase II trial randomly compared the efficacy and toxicity of pegylated liposomal doxorubicin versus continuous-infusion doxorubicin in patients ≥55 years with Philadelphia chromosome-negative ALL. Design and Methods. Sixty patients received either continuous infusion-Doxorubicin (12 mg/m²/d) and continuous infusion-vincristine (0.4 mg/day) on day1-4 or liposomal-Doxorubicin (40 mg/m2;) and standard vincristine (2 mg) on day1, accompanied by dexamethasone, followed at day 28 by a second cycle, reinforced by cyclophosphamide. Endpoints were safety, outcome and prognostic factors. Results. Myelosupression was reduced in the Peg-Dox arm with shorter severe neutropenia (P=0.05), shorter severe thrombocytopenia (P=0.03), and less erythrocytes transfusions (P=0.04). Grade 3/4 infections and gram-negative bacteremia were reduced in the Peg-Dox arm (P=0.04 and ...
The British Society for Haematology is registered in England and Wales as a Company Limited by Guarantee, No 2645706 and as a Charity, No 1005735 Registered Office and correspondence address: 100 White Lion Street London N1 9PF. Phone: 020 7713 0990 ...
Constipation in advanced cancer • Delirium in Adult Cancer • Diarrhoea in adult cancer patients Patients • Management of anaemia and iron deficiency in patients with cancer • Management of infusion reactions to systemic anticancer therapy • Management of toxicities from immunotherapy • Management of febrile neutropaenia • MASCC and ESMO consensus guidelines for the prevention of chemotherapy and radiotherapy-induced nausea and vomiting • Treatment of dyspnoea in advanced cancer patients • Central venous access in oncology • Management of oral and gastrointestinal mucosal injury • Management of refractory symptoms at the end of life and the use of palliative sedation • Advanced care planning in palliative care • Bone health in cancer patients • Cancer, fertility and pregnancy • Management of chemotherapy extravasation • Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy • Management of cancer ...
Bone Metastasis-Free Survival. The median follow-up was 67.2 months in the denosumab group and 67.3 months in the placebo group. Median bone metastasis-free survival was not reached in either group (hazard ratio [HR] = 0.97, 95% confidence interval [CI] = 0.82-1.14, P = .70). Bone metastasis-free survival events occurred in 13% of the denosumab group vs 14% of the placebo group, including bone events in 7% vs 8%. Median disease-free survival was not reached in either group (HR = 1.04, P = .57). Disease-free survival events occurred in 20% vs 19% of patients.. Adverse Events. The most common grade ≥ 3 adverse events were neutropenia (15% vs 15%), febrile neutropenia (5% vs 6%), and leukopenia (3% vs 3%). Positively adjudicated osteonecrosis of the jaw occurred in 5% vs , 1% of patients. Atypical femur fracture occurred in nine patients (, 1%) vs no patients. Hypocalcemia of ...
An investigation of the relationships between physicochemical features of ten antipsychotic drugs and previously reported influence of these drugs on neutrophil maturity was made. A quantitative structure-activity relations (QSAR) approach was adopted, in which several numerical parameters describing physicochemical characteristics of the antipsychotics were estimated. Possible connections between these parameters and neutrophil maturity were explored. Influence of drug physicochemistry on the incidence of agranulocytosis and neutropenia reported in the literature was documented. Overall it was found that drugs with the greatest tendency to induce neutrophil immaturity (chlorpromazine, clozapine and olanzapine) also showed the greatest tendency to cause agranulocytosis and neutropenia. Moreover marked induction of neutrophil immaturity occurred with compounds of moderately amphipathic character, whose amphipathic indices (AI) fell in the ...
Results Among 47 patients, 5-FU plasma concentration monitoring was carried out a total of 289 times. The area under the receiver operating characteristic (ROC) curve (AUC) reflecting 5-FU exposure in vivo was 2.8-158 mg*h/L (41±94.6 mg*h/L). Mean AUC range within the target range (20-30 mg*h/L) for each patient was observed in 28.8% of patients. The overall incidence of related severe adverse reactions in the AUC ≤30 mg*h/L group was lower than that in the ,30 mg*h/L group (24.0% and 50.0%, respectively) (p=0.06), and the incidence of severe neutropenia was 12.0% and 40.9%, respectively (p=0.05). The disease control rate and overall response rate of the AUC ,20 mg*h/L group was lower than that of the ≥20 mg*h/L group: 83.3% vs 97.1% (p=0.19) and 25.0% vs 51.4% (p = 0.10), respectively. ...
Germline GATA2 gene mutations, leading to haploinsufficiency have been identified in patients with familial myelodysplastic syndrome/ acute myeloid leukemia (MDS/AML), monocytopenia and mycobacterial infections (MonoMAC), Emberger syndrome, and dendritic cell, monocyte, B and NK-cell deficiency (DCML). GATA2 mutations have also been reported in a minority of patients with congenital neutropenia and aplastic anemia (AA). The bone marrow (BM) from patients with GATA2 deficiency is typically hypocellular with varying degrees of dysplasia. Distinguishing

Nivestim 12 MU/ 0.2 ml solution for injection/infusion, Nivestim 30 MU/ 0.5 ml solution for injection/infusion, Nivestim 48MU/...Nivestim 12 MU/ 0.2 ml solution for injection/infusion, Nivestim 30 MU/ 0.5 ml solution for injection/infusion, Nivestim 48MU/...

The safety and efficacy in neonates and patients with autoimmune neutropenia have not been established. ... Filgrastim is indicated for the reduction in the duration of neutropenia and the incidence of febrile neutropenia in patients ... It is currently unclear whether long-term treatment of patients with severe chronic neutropenia will predispose patients to ... Data are presented separately for cancer patients, PBPC mobilisation in normal donors, SCN patients and patients with HIV, ...
more infohttps://www.medicines.org.uk/emc/product/575

Matsui K[au] - PubMed - NCBIMatsui K[au] - PubMed - NCBI

Efficacy of using trimethoprim-sulfamethoxazole prophylaxis in an adult patient with autoimmune neutropenia. ... Clinical Characteristics of Patients with Spondyloarthritis in Japan in Comparison with Other Regions of the World. ... Remarkable Improvement of Cardiac Function After Pre-emptive Kidney Transplant in a Patient With Severe Mitral Regurgitation ... Delayed onset of metronidazole-induced encephalopathy in a patient with systemic sclerosis accompanied by intestinal pseudo- ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed?cmd=search&term=Matsui+K%5Bau%5D&dispmax=50

Studies Find High Prevalence, Cost of Neutropenia in Pediatric Patients With Autoimmune Disease - AJMC.com Managed Markets...Studies Find High Prevalence, Cost of Neutropenia in Pediatric Patients With Autoimmune Disease - AJMC.com Managed Markets...

Pediatric patients with autoimmune neutropenia have a higher prevalence and cost than previously suspected, according to the ... Studies Find High Prevalence, Cost of Neutropenia in Pediatric Patients With Autoimmune Disease AJMC.com Managed Markets ... Studies Find High Prevalence, Cost of Neutropenia in Pediatric Patients With Autoimmune Disease - AJMC.com Managed Markets ...
more infohttps://globalgenes.org/news/studies-find-high-prevalence-cost-of-neutropenia-in-pediatric-patients-with-autoimmune-disease-ajmc-com-managed-markets-network/

1 - Price action forex trading explained1 - Price action forex trading explained

In contrast, neutrophil consumption in patients with autoimmune neutropenia and hypersplenism can outstrip marrow production. ... The nystagmus seen in patients with vestibular lesions and the internuclear ophthalmoplegia seen in some patients with multiple ... Of the 10 evaluable patients, dividing the RMSE by 10 multi- plies the PSNR by 2. Clinical Uses An erythromycin is the drug of ... All these tests should be done in patients in both the best on and practi- cally defined off states. 1996c), gas, electricity, ...
more infohttp://fin-forex.com/price-action-forex-trading-explained.html

The use of intravenous gamma-globulin in idiopathic thrombocytopenic purpura. - Plasma Protein Therapeutics Association (PPTA)The use of intravenous gamma-globulin in idiopathic thrombocytopenic purpura. - Plasma Protein Therapeutics Association (PPTA)

Reports of effective treatment of patients with autoimmune neutropenia and autoimmune hemolytic anemia by IVIG broadened the ... Studies in children with acute ITP demonstrated that administration of IVIG was the fastest way to increase a patients ... ITP suggested that repeated infusions were a safe and effective way to maintain an adequate platelet count in such patients, ...
more infohttps://www.pptaglobal.org/plasma-products-databases/immunoglobulin/hematology/650-the-use-of-intravenous-gamma-globulin-in-idiopathic-thrombocytopenic-purpura

Hematological changes as the initial manifestation of primary Sjögrens syndrome | Revista Colombiana de Reumatología (English...Hematological changes as the initial manifestation of primary Sjögren's syndrome | Revista Colombiana de Reumatología (English...

Hematological alterations are a frequent finding in different autoimmune diseases, being found in up to 25-50% of patients. ... associated with autoimmune neutropenia or lymphopenia, usually with a chronic presentation; however, in some occasions they may ... Patients with primary Sjögrens syndrome may develop hematological alterations as an initial manifestation in 5-10% of cases.2 ... Sjögrens syndrome occurs in patients of all ages, predominantly in women between 40 and 50 years of age.1 It is classified as ...
more infohttps://www.elsevier.es/en-revista-revista-colombiana-reumatologia-english-edition--474-articulo-hematological-changes-as-initial-manifestation-S244444051830030X

Auto-immune neutropenia occurring in association with malignant melanomaAuto-immune neutropenia occurring in association with malignant melanoma

We report a case of auto-immune neutropenia occurring in a patient with metastatic melanoma, and discuss the differential ... Auto-immune neutropenia occurring in association with malignant melanoma. *Authors: *J. D. White ... White, J.D., MacPherson, I.J., & Evans, T.J. (2003). Auto-immune neutropenia occurring in association with malignant melanoma. ... White, J. D., MacPherson, I. J., Evans, T. J.Auto-immune neutropenia occurring in association with malignant melanoma. ...
more infohttps://www.spandidos-publications.com/or/10/1/249

Autoimmune neutropenia - WikipediaAutoimmune neutropenia - Wikipedia

In 80 percent of patients, neutropenia persisted for 7 to 24 months. Diagnosis Patients with autoimmune neutropenia are ... Consequently, patients with autoimmune neutropenia have low levels of granulocytic neutrophilic white blood cells causing a ... Autoimmune neutropenia is a form of neutropenia which is most common in infants and young children where the body identifies ... Primary autoimmune neutropenia (AIN) is an autoimmune disease first reported in 1975 that primarily occurs in infancy. In ...
more infohttps://en.wikipedia.org/wiki/Autoimmune_neutropenia

Enkephalin degradating enzymes in pheochromocytoma patients.Enkephalin degradating enzymes in pheochromocytoma patients.

Previous Document: Auto-immune neutropenia occurring in association with malignant melanoma.. Next Document: Chemoprevention of ... We assumed that altered enkephalin level in pheochromocytoma patients (but not in patients with non-functional adenomas or ... In all pheochromocytoma patients NEP activity was reduced almost to the control level after surgery. At the same time APN ... Catheholamines and vanyllmandelic acid (VMA) were measured in 24-h urine of pheochromocytoma patients. NEP and APN activity on ...
more infohttp://www.biomedsearch.com/nih/Enkephalin-degradating-enzymes-in-pheochromocytoma/12469178.html

Gammagard S/D Advanced Patient Information - Drugs.comGammagard S/D Advanced Patient Information - Drugs.com

Autoimmune Neutropenia Octagam, immune globulin intravenous, Carimune, Gammaplex, Flebogamma, More.... Evans Syndrome ... The Gammagard Liquid, Gammaked™, Gamunex®-C, and Hizentra® products may be given at home to patients who do not need to be in ... and death may occur in predisposed patients who receive immune globulin IV (IGIV) products. Patients predisposed to renal ... Patients with idiopathic thrombocytopenic purpura (ITP) should not be treated with Gammaked™ or Gamunex®-C that is injected ...
more infohttps://www.drugs.com/cons/gammagard-s-d.html

Antimicrobial Agents in Neutropenic Cancer Patients: RecommendationsAntimicrobial Agents in Neutropenic Cancer Patients: Recommendations

Pediatric Autoimmune and Chronic Benign Neutropenia * Fast Five Quiz: How Much Do You Know About Neutropenia? ... Patients should be observed for ≥ 4 hours before discharge. Patients with febrile neutropenia who are at low risk of medical ... Patients who present with febrile neutropenia within 65 weeks after receiving chemotherapy should be assessed within 15 minutes ... Risk of febrile neutropenia should be systematically assessed, with consideration of patient-related, cancer-related, and ...
more infohttps://emedicine.medscape.com/article/2500036-overview

Panglobulin NF Advanced Patient Information - Drugs.comPanglobulin NF Advanced Patient Information - Drugs.com

Autoimmune Neutropenia Octagam, immune globulin intravenous, Carimune, Gammaplex, Flebogamma, Gammagard S / D, More... ... The Gammagard Liquid, Gammaked™, Gamunex®-C, and Hizentra® products may be given at home to patients who do not need to be in ... and death may occur in predisposed patients who receive immune globulin IV (IGIV) products. Patients predisposed to renal ... Patients with idiopathic thrombocytopenic purpura (ITP) should not be treated with Gammaked™ or Gamunex®-C that is injected ...
more infohttps://www.drugs.com/cons/panglobulin-nf.html

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Autoimmune neutropenia: clinical and laboratory studies in 143 patients. (This classic manuscript forex trading sessions cst ... Infection control issues IN THE Stick OF patients Streptococcus pyogenes (b Haemolytic Streptococcus Lancefield Group A) ... atic patients with aneurysms. When warmed the liquid expands causing a column of liquid to rise up the capillary forex session ... or to do the same for yourself if youre the patient). Quite a bargain for a few dollars. 5 5-3 product-OF-sums boolean ...
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Safety and Efficacy Study of Romiplostim to Treat Immune Thrombocytopenia (ITP) in Pediatric Patients - Tabular View -...Safety and Efficacy Study of Romiplostim to Treat Immune Thrombocytopenia (ITP) in Pediatric Patients - Tabular View -...

Known history of systemic lupus erythematosus, evans syndrome, or autoimmune neutropenia. *Known history of antiphospholipid ... Safety and Efficacy Study of Romiplostim to Treat Immune Thrombocytopenia (ITP) in Pediatric Patients. This study has been ... requires in-patient hospitalization or prolongation of existing hospitalization,. *results in persistent or significant ... The purpose of this study is to evaluate the efficacy of romiplostim in the treatment of thrombocytopenia in pediatric patients ...
more infohttps://clinicaltrials.gov/ct2/show/record/NCT01444417?term=20080279&rank=1

Efficacy and Safety of Vivaglobin® in Previously Untreated Patients With Primary Immunodeficiency - Full Text View -...Efficacy and Safety of Vivaglobin® in Previously Untreated Patients With Primary Immunodeficiency - Full Text View -...

Any medical disorder causing secondary immune disorders, autoimmune neutropenia, or a clinically significant defect in cell ... Proportion of Patients Achieving IgG Levels ≥ 5 g/L on Day 19 [ Time Frame: On Day 19 ]. *Proportion of Patients Achieving IgG ... The annualized rate was based on the total number of infections and the total number of patient study days for all patients in ... Number of Patients With Adverse Events (AEs) by Severity and Relatedness [ Time Frame: For the duration of the study, up to ...
more infohttps://clinicaltrials.gov/ct2/show/NCT00520494?term=%E2%80%A2%09Immunodeficiency+NOT+

Pediatric Bruton Agammaglobulinemia Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient...Pediatric Bruton Agammaglobulinemia Follow-up: Further Outpatient Care, Further Inpatient Care, Inpatient & Outpatient...

Autoimmune hemolytic anemia and autoimmune neutropenia were confirmed based on the presence of autoantibodies. The patient has ... and autoimmune neutropenia. One center reported that 26.7% of XLA patients have developed neutropenia. [68] There have been ... Autoimmune diseases (eg, inflammatory bowel disease, atrophic gastritis, pernicious anemia) are also observed in patients. ... Interestingly, patients with XLA who receive early and adequate IgG replacement seem to do better than patients with other ...
more infohttps://emedicine.medscape.com/article/885625-followup

Severe Chronic Neutropenia - NORD (National Organization for Rare Disorders)Severe Chronic Neutropenia - NORD (National Organization for Rare Disorders)

Curiously enough, although the blood level of neutrophils is low in patients with autoimmune neutropenia, these children are ... Autoimmune neutropenia is distinct from severe chronic neutropenia in terms of the cause of neutropenia. The severe chronic ... Severe chronic neutropenia: treatment and follow-up of patients in the Severe Chronic Neutropenia International Registry. Am J ... Cyclic neutropenia and severe congenital The neutropenia in patients with a shared ELANE mutation and paternal haplotype: ...
more infohttps://rarediseases.org/rare-diseases/severe-chronic-neutropenia/

Neutrophil Antibody Specificity in Different Types of Childhood Autoimmune Neutropenia | Blood | American Society of HematologyNeutrophil Antibody Specificity in Different Types of Childhood Autoimmune Neutropenia | Blood | American Society of Hematology

In primary AIN, neutropenia is the sole abnormality, and although neutrophil co ... Autoimmune neutropenia (AIN) in children can be divided into 2 forms. ... In 2 patients, neutropenia was the presenting problem. One of these patients showed neutropenia at the age of 6 months. Ten ... One of these last 2 patients has a neutropenia persisting for more than 5 years now. In the other patient, neutropenia ...
more infohttps://ashpublications.org/blood/article/94/5/1797/250632/Neutrophil-Antibody-Specificity-in-Different-Types

RAG1 | Cancer Genetics WebRAG1 | Cancer Genetics Web

RESULTS: The 14-year-old patient, who had liver granuloma, extranodal marginal zone B-cell lymphoma, and autoimmune neutropenia ... Programs to optimize patient-specific therapy using patient-derived xenograft tumor growth in NSG mice have been established at ... METHODS: A patient given a diagnosis of CVID, who was born to a consanguineous family and thus would be expected to show an ... CONCLUSIONS: Biomarkers of DNA repair and cell cycle control can identify patients at high risk of treatment failure in those ...
more infohttp://www.cancerindex.org/geneweb/RAG1.htm

Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States  |...Serious Bacterial Infections Acquired During Treatment of Patients Given a Diagnosis of Chronic Lyme Disease - United States |...

This report from CDCs MMWR looks at serious bacterial infections acquired during treatment of patients given a diagnosis of ... This report from CDCs MMWR looks at serious bacterial infections acquired during treatment of patients given a diagnosis of ... Patient E. A woman in her 60s with autoimmune neutropenia, mixed connective tissue disease, and degenerative arthritis received ... and missed opportunities to diagnose and treat the actual underlying cause of the patients symptoms (8,10).†,§ Patients and ...
more infohttps://www.cdc.gov/mmwr/volumes/66/wr/mm6623a3.htm

JCI -
IL-21 drives secondary autoimmunity in patients with multiple sclerosis, following therapeutic lymphocyte depletion with...JCI - IL-21 drives secondary autoimmunity in patients with multiple sclerosis, following therapeutic lymphocyte depletion with...

We have also observed 2 cases of Goodpasture disease and 1 case each of autoimmune neutropenia (1) and autoimmune hemolytic ... Seventy-three patients gave consent for DNA analysis; of these, 27 patients met the criteria for autoimmunity and 23 patients ... Characteristics of autoimmune thyroid disease occurring as a late complication of immune reconstitution in patients with ... Sample and patient selection. (A) Apoptosis and proliferation were performed on fresh ex vivo samples. Sixty-five patients were ...
more infohttps://www.jci.org/articles/view/37878

NeutropeniaNeutropenia

Chronic autoimmune neutropenia is observed in adults and has no age predilection. As many as 36% of patients will exhibit serum ... Autoimmune neutropenia is the neutrophil analogue of autoimmune hemolytic anemia and of idiopathic thrombocytopenic neutropenia ... Tests for antineutrophil antibodies should be performed in patients with a history suggestive of autoimmune neutropenia and in ... Patients with cyclic or idiopathic neutropenia appear to benefit at lower doses of G-CSF than those with congenital neutropenia ...
more infohttp://misc.medscape.com/pi/iphone/medscapeapp/html/A204821-business.html

Autoimmune Neutropenia Updates: Etiology, Pathology, and TreatmentAutoimmune Neutropenia Updates: Etiology, Pathology, and Treatment

... destruction of neutrophils from an underlying autoimmune mechanism in which autoantibodies are directed against a patients own ... AbstractAutoimmune neutropenia (AIN) is defined as a neutrophil count ,1.5 × 109/L caused by increased peripheral ... Autoimmune neutropenia (AIN) is defined as a neutrophil count 9/L caused by increased peripheral destruction of neutrophils ... from an underlying autoimmune mechanism in which autoantibodies are directed against a patients own neutrophils. AIN has a ...
more infohttps://insights.ovid.com/southern-medical/smeda/2017/04/000/autoimmune-neutropenia-updates/14/00007611

Aplastic crisis legal definition of aplastic crisisAplastic crisis legal definition of aplastic crisis

... neutropenia, autoimmune thrombocytopenic purpura, pancytopenia) are also seen in immunocompetent patients (4), (5), (7-10), (39 ... Acute splenic sequestration together with aplastic crisis caused by human parvovirus B19 in patients with sickle cell disease. ... The virus is strongly associated with erythema infectiosum (fifth disease), the transient aplastic crisis observed in patients ...
more infohttps://legal-dictionary.thefreedictionary.com/aplastic+crisis

p53 Vaccine for Ovarian Cancer - Full Text View - ClinicalTrials.govp53 Vaccine for Ovarian Cancer - Full Text View - ClinicalTrials.gov

Patients with underlying immune deficiency or history of autoimmune disease e.g. (autoimmune neutropenia, thrombocytopenia, or ... Patients should have ovarian cancer with marker only disease or patients with stage III, IV or recurrent who are NED post ... And the patient should have recovered from all acute toxicities of previous treatment. Patients who received bone marrow ... Patients with active infections requiring antibiotics. Patients requiring chronic suppressive antibiotics will be eligible for ...
more infohttps://www.clinicaltrials.gov/ct2/show/NCT00001827
  • Extensive diagnostic tests including CSF analyses with polymerase chain reaction (PCR) for viral genomes, neuroimaging, and electrophysiologic studies need to be pursued to evaluate for infectious or autoimmune complications. (medscape.com)
  • The higher risk of CV disease in patients with RA is generally thought to be due to the increased inflammatory burden, which causes accelerated atherosclerosis [ 6 ], as well as a greater prevalence of traditional risk factors (hypertension, dyslipidemia, and smoking) [ 1 , 7 , 8 ]. (hindawi.com)
  • Prevalence of neutropenia in the U.S. population: age, sex, smoking status, and ethnic differences. (bmj.com)
  • We analyzed clinical and serological data from 28 pediatric patients with AIN to evaluate whether there is a possible relationship between specificity of the neutrophil autoantibodies and the clinical course of the disease. (ashpublications.org)
  • Fever in neutropenic patients is defined as a single oral temperature of ≥ 38.3°C (101°F) or a temperature of ≥ 38.0°C (100.4°F) sustained over 1 hour. (medscape.com)
  • Less frequently, neutropenia is due to infiltration of the bone marrow by malignant disease. (spandidos-publications.com)
  • If end-stage lung disease develops, lung transplantation has been performed in patients with agammaglobulinemia using intensive IVIG administration (every 48 h during the first 10 d after transplant). (medscape.com)
  • Patients with a known family history of SCN are most at risk for the disease. (oncologynurseadvisor.com)
  • Investigations conducted by Sarah E Flanagan and Mark Russell from the Institute of Biomedical and Clinical Science, University of Exeter Medical School, Emma Haapaniemi from the Institute of Biomedical and Clinical Science, University of Exeter Medical Schoolby, and Joshua Milner from the National Institute of Allergy and Infectious Disease, National Institutes of Health have described this condition in 19 patients. (wikipedia.org)
  • Magnetic resonance imaging (MRI) showed inflammatory lesions, confirmed by pathology for five patients with macrophagic or lymphoplasmocytic infiltrates. (springermedizin.de)
  • The duration of Filgrastim therapy needed to attenuate chemotherapy-induced neutropenia may be dependent on the myelosuppressive potential of the chemotherapy regimen employed. (wikidoc.org)
  • These patients now have a new, targeted therapy that inhibits a protein involved in keeping tumor cells alive," said Richard Pazdur, director of the Office of Hematology and Oncology Products in the FDA's Center for Drug Evaluation and Research. (fda.gov)
  • Ltd, Korea) was compared with the Automated hematology Analyzer method (KX-21N sysmex, USA) using paired data of blood samples analyzed respectively from 206 patients in the hospital. (vixra.org)
  • However, 30% of patients develop autoimmunity months to years after pulsed exposure to alemtuzumab, usually targeting the thyroid gland and, more rarely, blood components. (jci.org)
  • In this study, we show that autoimmunity arose in those patients with greater T cell apoptosis and cell cycling in response to alemtuzumab-induced lymphocyte depletion, a phenomenon that is driven by higher levels of IL-21. (jci.org)
  • Recommendations for the frequency of laboratory monitoring of serum lipids, liver transaminases, serum creatinine, neutrophil counts, and platelet counts in patients with RA were compiled from a literature search for published recommendations and guidelines as well as the prescribing information for each drug. (hindawi.com)
  • Patients predisposed to renal dysfunction include those with any degree of preexisting renal insufficiency, diabetes mellitus, age greater than 65, volume depletion, sepsis, paraproteinemia, or patients receiving known nephrotoxic drugs. (drugs.com)
  • Immune globulin-ifas does not contain sucrose.For patients at risk of thrombosis, renal dysfunction, or renal failure, administer immune globulin-ifas at the minimum infusion rate practicable. (drugs.com)
  • We assumed that altered enkephalin level in pheochromocytoma patients (but not in patients with non-functional adenomas or tumors of different origin) might result in differently regulated APN and/or NEP activity. (biomedsearch.com)
  • In this protocol we will be vaccinating HLA-A2+ ovarian cancer patients who carry tumors which overexpress p53 with the wild type p53 peptide (264-272). (clinicaltrials.gov)