American Journal of BioMedicine
Volume 11, Issue 3, 2023, Pages 136-142 | http://dx.doi.org/10.18081/2333-5106/2023.11/136
Marina Tinôco, de Lima Tupinambás *1
Received 28 February 2023; Revised 30 May 2023; Accepted 29 June 2023; Published 19 August 2023
Neutropenia following chemotherapy regimens in leukemia patients is of main pressing issue since it makes these patients powerless against contamination. On the off chance that we can recognize which microorganisms are causing these contaminations, they can be destroyed, or, at any rate, the most proper anti-microbial treatment can be begun right away, even before we have the aftereffects of the way of life. Over the past four decades, the range of bacterial isolates has changed a lot. The goal of the current study was to assess the example of bacterial and contagious diseases in acute lymphoblastic Leukemia neutropenic patients. A non-randomized graphic and cross-sectional review including 55 hospitalized patients was completed at the hematology department from December 2020 to December 2022. Neutropenic patients mostly children’s patients with clinical indications of contamination or potential fever were signed up for the participation. The resulting data contained 55 febrile as well as contaminated neutropenic episodes happening in 30 male and 25 female more youthful of age with a mean period of 32.14±4.23 years. A sum of 34 microorganisms was refined: 60.5% from other locations and 39.5% from the urinary tract; 70.2% were gram-negative microbes, 19.8% were gram-positive microscopic organisms, and 10% were growth. Pseudomonas aeruginosa and staphylococcus aureus were the most successive gram-negative and gram-positive detaches separately. Candida spp. was the only fungus found isolated. In conclusion, Gram-negative micro-organisms remained the most prevalent pathogens isolated in this result in the study population, and the patterns of isolates in neutropenic patients with lymphocytic leukemia (ALL) vary from region to region, therapeutic adjustments for empirical antibiotic therapy are likely to focus on gram-negative pathogens.
Keywords: Lymphocytic leukemia; Neutropenia; Gram-negative micro-organisms
Copyright © 2023 Tupinambás et al. This article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
|1. Vadillo E, Dorantes-Acosta E, Pelayo R, et al. T cell acute lymphoblastic leukemia (T-ALL): new insights into the cellular origins and infiltration mechanisms common and unique among hematologic malignancies. Blood Rev 2018; 32(1):36-51.
|2. Wu C, Li W. Genomics and pharmacogenomics of pediatric acute lymphoblastic leukemia. Crit Rev Oncol Hematol 2018; 126:100-111.
|3. Lange CS, Rahrig A, Althouse SK, Nelson RP, Batra S. Hypogammaglobulinemia in Adolescents and Young Adults with Acute Lymphoblastic Leukemia. J Adolesc Young Adult Oncol 2020; 9(6):687-692.
|4. Kahloun R, Abroug N, Ksiaa I, et al. Infectious optic neuropathies: a clinical update. Eye Brain 2015; 7:59-81.
|5. Nesher L, Rolston KV. The current spectrum of infection in cancer patients with chemotherapy related neutropenia. Infection 2014; 42(1):5-13.
|6. Zimmer AJ, Freifeld AG. Optimal management of neutropenic fever in patients with cancer. J Oncol Pract 2019; 15(1):19-24.
|7. Averbuch D, Orasch C, Cordonnier C, et al.; ECIL4, a joint venture of EBMT, EORTC, ICHS, ESGICH/ESCMID and ELN. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica 2013; 98(12):1826-1835.
|8. de Marie S, van den Broek PJ, Willemze R, van Furth R. Strategy for antibiotic therapy in febrile neutropenic patients on selective antibiotic decontamination. Eur J Clin Microbiol Infect Dis 1993; 12(12):897-906.
|9. Slobbe L, Waal L, Jongman LR, Lugtenburg PJ, Rijnders BJ. Three-day treatment with imipenem for unexplained fever during prolonged neutropaenia in haematology patients receiving fluoroquinolone and fluconazole prophylaxis: a prospective observational safety study. Eur J Cancer 2009; 45(16):2810-2817.
|10. Cornelissen JJ, Rozenberg-Arska M, Dekker AW. Discontinuation of intravenous antibiotic therapy during persistent neutropenia in patients receiving prophylaxis with oral ciprofloxacin. Clin Infect Dis 1995; 21(5):1300-1302.
|11. Le Clech L, Talarmin JP, Couturier MA, et al. Early discontinuation of empirical antibacterial therapy in febrile neutropenia: the ANTIBIOSTOP study. Infect Dis (Lond) 2018; 50(7):539-549.
|12. Wingard JR, Carter SL, Walsh TJ, et al. Blood and Marrow Transplant Clinical Trials Network. Randomized, double-blind trial of fluconazole versus voriconazole for prevention of invasive fungal infection after allogeneic hematopoietic cell transplantation. Blood 2010; 116(24):5111-5118.
|13. Cumpston A, Caddell R, Shillingburg A, et al. Superior serum concentrations with posaconazole delayed-release tablets compared to suspension formulation in hematological malignancies. Antimicrob Agents Chemother 2015; 59(8):4424-4428.
|14. Cornely OA, Böhme A, Schmitt-Hoffmann A, Ullmann AJ. Safety and pharmacokinetics of isavuconazole as antifungal prophylaxis in acute myeloid leukemia patients with neutropenia: results of a phase 2, dose escalation study. Antimicrob Agents Chemother 2015; 59(4):2078-2085.
|15. Hill JA, Seo SK. How I prevent infections in patients receiving CD19-targeted chimeric antigen receptor T cells for B-cell malignancies. Blood 2020;136(8):925-935.
|16. Mikulska M, Lanini S, Gudiol C, et al. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (agents targeting lymphoid cells surface antigens [I]: CD19, CD20 and CD52). Clin Microbiol Infect 2018; 24(suppl 2):S71-S82.
|17. Reinwald M, Silva JT, Mueller NJ, et al.. ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: an infectious diseases perspective (Intracellular signaling pathways: tyrosine kinase and mTOR inhibitors). Clin Microbiol Infect 2018; 24(suppl 2):S53-S70.
|18. Schaeffeler E, Jaeger SU, Klumpp V, Yang JJ, Igel S, Hinze L, Stanulla M, Schwab M. Impact of NUDT15 genetics on severe thiopurine-related hematotoxicity in patients with European ancestry. Genet. Med. 2019; 21:2145-2150.
|19. Cargnin S, Genazzani AA, Canonico PL, Terrazzino S. Diagnostic accuracy of NUDT15 gene variants for thiopurine-induced leukopenia: a systematic review and meta-analysis. Pharmacol. Res 2018; 135:102-111.
|20. Puangpetch A, Tiyasirichokchai R, Pakakasama S, Wiwattanakul S, Anurathapan U, Hongeng S, Sukasem C. NUDT15 genetic variants are related to thiopurine-induced neutropenia in Thai children with acute lymphoblastic leukemia. Pharmacogenomics 2020; 21:403-410.
|21. Nghia H, Than HH, Dong CV, et al. The effects of NUDT15 and TPMT variants on mercaptopurine treatment in Vietnamese pediatric acute lymphoblastic leukemia patients. Pediatr. Hematol. Oncol 2022; 39:561-570.
|22. Tanaka Y, Nakadate H, Kondoh K, Nakamura K, Manabe A. Interaction between NUDT15 and ABCC4 variants enhances intolerability of 6-mercaptopurine in Japanese patients with childhood acute lymphoblastic leukemia. Pharmacogenomics J 2018; 18:275-280.
|23. Pui CH, Yang JJ, Hunger SP, et al. Childhood acute lymphoblastic leukemia: progress through collaboration. J Clin Oncol 2015; 33:2938-2948.
|24. Gafter-Gvili A, Fraser A, Paul M, et al. Antibiotic prophylaxis for bacterial infections in afebrile neutropenic patients following chemotherapy. Cochrane Database Syst Rev 2012;1.
Tinôco M, Tupinambás dL. Neutropenic acute lymphocytic leukemia patients with different patterns of bacterial Infections . American Journal of BioMedicine 2023; 11(3):136-143.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in American Journal of BioMedicine are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.