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Febrile neutropenia

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Chapter 081. Principles of Cancer Treatment (Part 20)

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Use if the probability of febrile neutropenia is ≥20%. Use if patient has preexisting neutropenia or active infection. Dose-dense regimens in a clinical trial or with strong evidence of benefit. With subsequent cycles if febrile neutropenia has previously occurred (so- called secondary CSF administration). Not needed after short duration neutropenia without fever. Use if patient had febrile neutropenia in previous cycle. Use if prolonged neutropenia (even without fever) delays therapy.

A clinical study of pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) in preventing neutropenia during concurrent chemoradiotherapy of cervical cancer

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The primary endpoints were the incidence of grade 3 – 4 neutropenia. Secondary endpoints included the duration of grade 3 – 4 neutropenia, the incidence of grade 4 neutropenia, the incidence of febrile neutropenia (FN), delay rate of chemotherapy, prolonged time of chemotherapy, time to complete radiotherapy and safety.. Results: The incidence of grade 3 – 4 neutropenia in the experimental group was significantly lower than the control group (10% vs.

Chapter 081. Principles of Cancer Treatment (Part 21)

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Primary prophylaxis (i.e., shortly after completing chemotherapy to reduce the nadir) of G-CSF to patients receiving cytotoxic regimens is associated with a 20% incidence of febrile neutropenia. regimens, where cycling of chemotherapy is intended to be completed without delay of administered doses, may also benefit, but such patients should be on a clinical trial. Administration of G-CSF in these circumstances has reduced the incidence of febrile neutropenia in several studies by about 50%.

Chapter 081. Principles of Cancer Treatment (Part 19)

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Management of febrile neutropenia has conventionally included empirical coverage with antibiotics for the duration of neutropenia (Chap. and Gram stain and culture of blood, urine, and sputum (if any) to define a putative site of infection. In the absence of any originating site, a broadly acting β-lactam with anti-Pseudomonas activity,. such as ceftazidime, is begun empirically.

The association between protease inhibitors and anal cancer outcomes in veterans living with HIV treated with definitive chemoradiation: A retrospective study

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While in our report there was an increase in hospitaliza- tions due to febrile neutropenia and other hematologic toxicities in patients taking PIs, their use was not associ- ated with treatment variables associated with reduced survival, such as ability to complete the entire course of radiation or chemotherapy dose reduction. Importantly, the use of PIs was not associated with changes in out- comes.

Meta-analysis and indirect treatment comparison of modified FOLFIRINOX and gemcitabine plus nab-paclitaxel as first-line chemotherapy in advanced pancreatic cancer

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For grade ≥ 3 adverse events, our ana- lysis showed that the risk was higher in patients treated with modified FOLFIRINOX than GEM-NAB including neutropenia, febrile neutropenia, thrombocytopenia, an- orexia, nausea and diarrhea. And lower risk of fatigue and anemia was observed in the modified FOLFIRINOX group than that of the GEM-NAB group.

Chapter 082. Infections in Patients with Cancer (Part 10)

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Paul M et al: Empirical antibiotic monotherapy for febrile neutropenia:. Ullmann AJ et al: Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease

Chapter 077. Approach to the Patient with Cancer (Part 5)

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The most common side effects of treatment are nausea and vomiting (see below), febrile neutropenia (Chap. Tools are now available to minimize the acute toxicity of cancer treatment.. New symptoms developing in the course of cancer treatment should always be assumed to be reversible until proven otherwise. The fatalistic attribution of anorexia, weight loss, and jaundice to recurrent or progressive tumor could result.

Phase II trial of nab-paclitaxel in metastatic breast cancer patients with visceral metastases

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Another phase two trial explored three different nab-paclitaxel doses (300 mg/m2 q3w, 100 mg/m2, or 150 mg/m2 qw) and docetaxel 100 mg/. m2 q3w for untreated patients with MBC and indicated that the 150 mg/m2 qw regimen of nab-paclitaxel showed extended progression free survival (PFS) than docetaxel (12.9 vs 7.5 months, P with lower rate of grade 3/4 neutropenia, febrile neutropenia, and fatigue, moreover, 84% patients in this trial had visceral metastases [11].

Modified FOLFIRINOX versus gemcitabine plus oxaliplatin as first-line chemotherapy for patients with locally advanced or metastatic cholangiocarcinoma: A retrospective comparative study

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However, grades 3–4 of febrile neutropenia, diarrhea and fatigue occurred only in the mFOLFIRINOX group, while grade 3–4 of thrombocytopenia occurred only in the Gemox group. Treatment was delayed because of toxicity in patients in the mFOLFIRINOX regimen and 3 (13.6%) patients in the Gemox regimen.. To our knowledge, this retrospective study was the first to directly compare the effectiveness between mFOLFIR- INOX and Gemox in patients with locally advanced or metastatic CCA.

Usefulness of procalcitonin (PCT), C-reactive protein (CRP), and white blood cell (WBC) levels in the diferential diagnosis of acute bacterial, viral, and mycoplasmal respiratory tract infections in children

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Predictive value of PCT and IL-6 for bacterial infection in children with cancer and febrile neutropenia. Feng M, Zhang SL, Liang ZJ, et al. Meili M, Kutz A, Briel M, et al. Infection biomarkers in primary care patients with acute respiratory tract infections-comparison of procalci- tonin and C-reactive protein. Giannini O, Giorno RD, Zasa A, et al. Comparative impact of C-reactive protein testing in hospitalized patients with acute respiratory tract infec- tion: a retrospective cohort study.

Second-line chemotherapy after early disease progression during first-line chemotherapy containing bevacizumab for patients with metastatic colorectal cancer

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In the BBP group, one patient (2.7%) had grade 3 febrile neutropenia. In the non-BBP group, 4 patients (16.0%) had grade 3–4 anemia and 2 patients (8.0%) had grade 3–4 anorexia. In the BBP group, hemorrhage, hypertension, proteinuria, embolism, and gastrointestinal perforation were rare..

A prospective phase-II trial of biweekly docetaxel plus androgen deprivation therapy in patients with previously-untreated metastatic castration-naïve prostate cancer

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Although the tri- weekly regimen was active to mCNPC [3, 4], relatively high incidence of febrile neutropenia was regarded as one of the major obstacles.

Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy

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Febrile neutropenia rates according to body mass index and dose capping in women receiving chemotherapy for early breast Cancer. The effect of obesity on pathological complete response and survival in breast cancer patients receiving uncapped doses of neoadjuvant anthracycline- taxane-based chemotherapy. Interaction between body mass index and hormone-receptor status as a prognostic factor in lymph-node-positive breast cancer.

Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 3)

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Approach to the Acutely Ill Infected Febrile Patient. Adjunctive treatments may reduce morbidity and mortality and include dexamethasone for bacterial meningitis. low-dose hydrocortisone and fludrocortisone for septic shock. and drotrecogin alfa (activated), also known as recombinant human activated protein C, for meningococcemia and severe sepsis.

CO GIẬT DO SỐT CAO (FEBRILE SEIZURE)

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Nếu đó chỉ là một co giật do sốt cao đơn giản (simple febrile seizure) và trạng thái thần kinh của đứa trẻ đã trở lại bình thường, những thăm dò cần được thực hiện không gì hơn là sự đánh giá căn bệnh gây sốt (febrile illness).. 8/ NGUY CƠ TÁI PHÁT SAU KHI TRẺ BỊ CO GIẬT DO SỐT CAO LẦN ĐẦU TIÊN.

Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 1)

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Approach to the Acutely Ill Infected Febrile Patient. Approach to the Acutely Ill Infected Febrile Patient: Introduction. The physician treating the acutely ill febrile patient must be able to recognize infections that require emergent attention. If such infections are not adequately evaluated and treated at initial presentation, the opportunity to alter an adverse outcome may be lost.

Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 7)

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In adults, this nonspecific febrile illness progresses to coma over several days. occasionally, coma occurs within hours and death within 24 h. On physical examination, symmetric encephalopathy is typical, and upper motor neuron dysfunction with decorticate and decerebrate posturing can be seen in advanced disease. Unrecognized infection results in a 20–30% mortality rate..

Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 4)

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Approach to the Acutely Ill Infected Febrile Patient. 18) Maculopapular rashes may reflect early meningococcal or rickettsial disease but are usually associated with nonemergent infections.. Exanthems are usually viral. Primary HIV infection commonly presents with a rash that is typically maculopapular and involves the upper part of the body but can spread to the palms and soles.

Chapter 115. Approach to the Acutely Ill Infected Febrile Patient (Part 2)

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Approach to the Acutely Ill Infected Febrile Patient. The Acutely Ill Patient: Treatment. In the acutely ill patient, empirical antibiotic therapy is critical and should be administered without undue delay. Increased prevalence of antibiotic resistance in community-acquired bacteria must be considered when antibiotics are selected.. Table 115-1 lists first-line treatments for infections considered in this chapter.