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1. Valera ET, Scrideli CA, Queiroz RG, Mori BM, Tone LG: Multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) gene expression in childhood acute lymphoblastic leukemia. Sao Paulo Med J; 2004 Jul 1;122(4):166-71
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  • [Title] Multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) gene expression in childhood acute lymphoblastic leukemia.
  • CONTEXT: Despite the advances in the cure rate for acute lymphoblastic leukemia, approximately 25% of affected children suffer relapses.
  • Expression of genes for the multiple drug resistance protein (MDR-1), multidrug resistance-related protein (MRP), and lung resistance protein (LRP) may confer the phenotype of resistance to the treatment of neoplasias.
  • OBJECTIVE: To analyze the expression of the MDR-1, MRP and LRP genes in children with a diagnosis of acute lymphoblastic leukemia via the semiquantitative reverse transcription polymerase chain reaction (RT-PCR), and to determine the correlation between expression and event-free survival and clinical and laboratory variables.
  • METHODS: Bone marrow aspirates from 30 children with a diagnosis of acute lymphoblastic leukemia were assessed for the expression of messenger RNA for the MDR-1, MRP and LRP genes by semi-quantitative RT-PCR.
  • The presence of the common acute lymphoblastic leukemia antigen (CALLA) was correlated with increased LRP expression (p = 0.009) and increased risk of relapse or death (p = 0.05).
  • The relative risk of relapse or death was six times higher among children with high LRP expression upon diagnosis (p = 0.05), as confirmed by multivariate analysis of the three genes studied (p = 0.035).
  • DISCUSSION: Cell resistance to drugs is a determinant of the response to chemotherapy and its detection via RT-PCR may be of clinical importance.
  • CONCLUSIONS: Evaluation of the expression of genes for resistance to antineoplastic drugs in childhood acute lymphoblastic leukemia upon diagnosis, and particularly the expression of the LRP gene, may be of clinical relevance, and should be the object of prospective studies.
  • [MeSH-major] Drug Resistance, Multiple / genetics. Gene Expression Regulation, Leukemic / genetics. Multidrug Resistance-Associated Proteins / genetics. Neoplasm Proteins / genetics. P-Glycoprotein / genetics. Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics. Vault Ribonucleoprotein Particles / genetics
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Child. Child, Preschool. Drug Resistance, Neoplasm / genetics. Epidemiologic Methods. Female. Genes, MDR / genetics. Humans. Infant. Male. Reverse Transcriptase Polymerase Chain Reaction

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  • (PMID = 15543372.001).
  • [ISSN] 1516-3180
  • [Journal-full-title] São Paulo medical journal = Revista paulista de medicina
  • [ISO-abbreviation] Sao Paulo Med J
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Multidrug Resistance-Associated Proteins; 0 / Neoplasm Proteins; 0 / P-Glycoprotein; 0 / Vault Ribonucleoprotein Particles; 0 / major vault protein
  • [Number-of-references] 20
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2. Al-Mohsen IZ, Sutton DA, Sigler L, Almodovar E, Mahgoub N, Frayha H, Al-Hajjar S, Rinaldi MG, Walsh TJ: Acrophialophora fusispora brain abscess in a child with acute lymphoblastic leukemia: review of cases and taxonomy. J Clin Microbiol; 2000 Dec;38(12):4569-76
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  • [Title] Acrophialophora fusispora brain abscess in a child with acute lymphoblastic leukemia: review of cases and taxonomy.
  • A 12-year-old girl with acute lymphoblastic leukemia was referred to King Faisal Specialist Hospital and Research Center.
  • The diagnosis without central nervous system (CNS) involvement was confirmed on admission, and chemotherapy was initiated according to the Children Cancer Group (CCG) 1882 protocol for high-risk-group leukemia.
  • During neutropenia amphotericin B (AMB) (1 mg/kg of body weight/day) was initiated for presumed fungal infection when a computed tomography (CT) scan of the chest revealed multiple nodular densities.
  • After 3 weeks of AMB therapy, a follow-up chest CT revealed progression of the pulmonary nodules.
  • Because of progression of pulmonary lesions while receiving AMB, antifungal therapy was changed to liposomal AMB (LAMB) (6 mg/kg/day).
  • Lung biopsy showed necrotizing fungal pneumonia with negative culture.
  • The dosage of LAMB was increased, and itraconazole (ITRA) was added; subsequently LAMB was discontinued and therapy was continued with ITRA alone.
  • [MeSH-major] Brain Abscess / microbiology. Mitosporic Fungi / classification. Precursor Cell Lymphoblastic Leukemia-Lymphoma / microbiology

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  • (PMID = 11101597.001).
  • [ISSN] 0095-1137
  • [Journal-full-title] Journal of clinical microbiology
  • [ISO-abbreviation] J. Clin. Microbiol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] UNITED STATES
  • [Other-IDs] NLM/ PMC87638
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3. Huh HJ, Park CJ, Jang S, Seo EJ, Chi HS, Lee JH, Lee KH, Seo JJ, Moon HN, Ghim T: Prognostic significance of multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression in acute leukemia. J Korean Med Sci; 2006 Apr;21(2):253-8
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  • [Title] Prognostic significance of multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression in acute leukemia.
  • We investigated whether multidrug resistance gene 1 (MDR1), multidrug resistance-related protein (MRP) and lung resistance protein (LRP) mRNA expression are associated with outcomes in acute leukemia patients.
  • At diagnosis we examined MDR1, MRP and LRP mRNA expression in bone marrow samples from 71 acute leukemia patients (39 myeloid, 32 lymphoblastic) using nested RT-PCR.
  • LRP mRNA expression was significantly associated with resistance to induction chemotherapy in acute leukemia patients, and in the AML proportion (p=0.02 and p=0.03, respectively).
  • Thus, determination of MDR gene expression at diagnosis appears likely to provide useful prognostic information for acute leukemia patients.
  • [MeSH-minor] Adolescent. Adult. Aged. Base Sequence. Child. Child, Preschool. Female. Gene Expression. Humans. Infant. Leukemia, Myeloid, Acute / drug therapy. Leukemia, Myeloid, Acute / genetics. Leukemia, Myeloid, Acute / mortality. Male. Middle Aged. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics. Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality. Prognosis. RNA, Messenger / genetics. RNA, Neoplasm / genetics. Survival Rate

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  • (PMID = 16614510.001).
  • [ISSN] 1011-8934
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Multidrug Resistance-Associated Proteins; 0 / Neoplasm Proteins; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Vault Ribonucleoprotein Particles; 0 / major vault protein
  • [Other-IDs] NLM/ PMC2734000
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4. Kaul DR, Lowe L, Visvesvara GS, Farmen S, Khaled YA, Yanik GA: Acanthamoeba infection in a patient with chronic graft-versus-host disease occurring during treatment with voriconazole. Transpl Infect Dis; 2008 Dec;10(6):437-41
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  • [Title] Acanthamoeba infection in a patient with chronic graft-versus-host disease occurring during treatment with voriconazole.
  • We report a case of disseminated infection with Acanthamoeba in a patient with graft-versus-host disease after hematopoietic stem cell transplant (HSCT) for acute lymphocytic leukemia.
  • The infection involved the brain, skin, and lungs and occurred despite treatment with voriconazole for mold prophylaxis, and did not respond to treatment with multiple other agents reported to have activity against Acanthamoeba.
  • [MeSH-major] Acanthamoeba / isolation & purification. Amebiasis / diagnosis. Antifungal Agents / adverse effects. Encephalitis / diagnosis. Graft vs Host Disease / prevention & control. Hematopoietic Stem Cell Transplantation / adverse effects. Precursor Cell Lymphoblastic Leukemia-Lymphoma / surgery. Pyrimidines / adverse effects. Triazoles / adverse effects
  • [MeSH-minor] Animals. Antiprotozoal Agents / therapeutic use. Drug Therapy, Combination. Fatal Outcome. Humans. Lung / parasitology. Lung / pathology. Male. Middle Aged. Phosphorylcholine / analogs & derivatives. Phosphorylcholine / therapeutic use. Skin / parasitology. Skin / pathology. Voriconazole

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  • (PMID = 18713138.001).
  • [ISSN] 1399-3062
  • [Journal-full-title] Transplant infectious disease : an official journal of the Transplantation Society
  • [ISO-abbreviation] Transpl Infect Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antifungal Agents; 0 / Antiprotozoal Agents; 0 / Pyrimidines; 0 / Triazoles; 107-73-3 / Phosphorylcholine; 53EY29W7EC / miltefosine; JFU09I87TR / Voriconazole
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5. Pazur M, Jelić-Puskarić B, Planinc-Peraica A, Vrhovac R, Kardum-Skelin I, Jaksić B: T lymphoblastic leukaemia with an unusual Burkitt lymphoma morphology--a case report. Coll Antropol; 2010 Jun;34(2):675-8
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  • [Title] T lymphoblastic leukaemia with an unusual Burkitt lymphoma morphology--a case report.
  • Precursor T-cell acute lymphoblastic leukaemia (T-ALL)/lymphoma (T-LBL) is a neoplasm with cytological features that include blast cells of medium size, high nuclear cytoplasmic ratio and inconspicuous nucleoli, which are usually TdT (Terminal Deoxynucleotidyl Transferase) positive and variably express T-cell markers.
  • Bone marrow aspiration revealed 87% and peripheral blood 41% of lymphoblasts with cytoplasmic vacuoles which suggested Burkitt lymphoma (BL) morphology.
  • This excluded Burkitt lymphoma and led to diagnosis of T-ALL.
  • The patient was submitted to two cycles of chemotherapy, autologous stem cell transplantation, and intrathecal chemotherapy, but he died after 10 months because of disease complications (lung aspergillosis and pleural effusion).
  • Beside morphologic criteria, setting correct diagnosis depends on identification of immunophenotype by flow cytometry and cytogenetic-molecular abnormalities.
  • Further improvements in the molecular definition of ALL subtypes, development of new and targeted drugs will improve patient's outcome and prognosis.
  • [MeSH-major] Burkitt Lymphoma / pathology. Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / pathology
  • [MeSH-minor] Antigens, CD2 / analysis. Bone Marrow / pathology. Cell Nucleus / pathology. Diagnosis, Differential. Fatal Outcome. Humans. Karyotyping. Lymphocytes / pathology. Male. Middle Aged

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  • (PMID = 20698152.001).
  • [ISSN] 0350-6134
  • [Journal-full-title] Collegium antropologicum
  • [ISO-abbreviation] Coll Antropol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Croatia
  • [Chemical-registry-number] 0 / Antigens, CD2
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6. Huang M, Zhou JF, Ran D, Zhang YC, Sun HY, Liu WL: [Ph+ acute lymphoblastic leukemia combined with lung and brain invasive aspergillosis]. Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2006 Jun;14(3):610-3
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  • [Title] [Ph+ acute lymphoblastic leukemia combined with lung and brain invasive aspergillosis].
  • This study was aimed to investigate the clinical features and therapy of Ph(+) acute lymphoblastic leukemia (Ph(+)ALL) combined with invasive aspergillosis.
  • A series of examination, including routine blood and bone marrow picture analysis, chest roentgenography, cranial computerized tomography and detection of cell genetics etc were carried out for a Ph(+)ALL patient combined with invasive aspergillosis.
  • This patient received chemotherapy with DVCP, idarubicin and imatinib mesylate and was treated with sporanox and amphotericin B (Amb; including Amb-L) and cerebrotomy for drainage because the invasive aspergillosis occurred during myelosuppression.
  • It is concluded that patient with Ph(+)ALL has poor prognosis despite intensive conventional chemotherapy, imatinib mesylate may prove to be an effective treatment for Ph(+)ALL.
  • Because detection rate of the fungus is very low, itraconazole in combination with surgical excision of focus is the best treatment of lung and brain invasive aspergillosis.


7. Matano S, Terahata S, Nakamura S, Kobayashi K, Sugimoto T: CD56-positive acute lymphoblastic leukemia. Acta Haematol; 2005;114(3):160-3
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  • [Title] CD56-positive acute lymphoblastic leukemia.
  • We report a patient with lung cancer who developed CD56-positive acute lymphoblastic leukemia.
  • There were no rearrangements of T-cell receptor (TCR)-beta, TCR-gamma, or immunoglobulin heavy chain.
  • Systemic examination did not detect any tumors other than pulmonary adenocarcinoma, and the patient was diagnosed as having acute natural killer (NK) cell leukemia.
  • Chemotherapy was effective, and he achieved complete remission.
  • The course of the disease was complicated by a lung abscess, and the patient died 3 months after the diagnosis.
  • We considered that the diagnosis was blastic NK cell lymphoma/leukemia subtype.
  • However, it actually was myeloid/NK cell precursor leukemia subtype that weakly expressed CD13.
  • [MeSH-major] Antigens, CD56 / metabolism. Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology

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  • [Copyright] (c) 2005 S. Karger AG, Basel
  • (PMID = 16227680.001).
  • [ISSN] 0001-5792
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antigens, CD56
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8. Gomyo H, Murayama T, Obayashi C, Mizuno I, Koizumi T, Imoto S: [Invasive pulmonary aspergillosis complicated by complete atrioventricular block and aspergillus pericarditis after induction chemotherapy in a patient with acute lymphoblastic leukemia]. Rinsho Ketsueki; 2003 Oct;44(10):1036-9
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  • [Title] [Invasive pulmonary aspergillosis complicated by complete atrioventricular block and aspergillus pericarditis after induction chemotherapy in a patient with acute lymphoblastic leukemia].
  • A 50-year-old man developed invasive pulmonary aspergillosis after induction chemotherapy for acute lymphoblastic leukemia.
  • During antifungal therapy, he developed aspergillus pericarditis and complete atrioventricular (A-V) block.
  • The pericardial effusion was decreased and the A-V block was improved after treatment with intravenous and intrapericardial instillation of AMPH-B.
  • This case indicates that LA is not sufficient for diagnosis and post therapy evaluation of invasive aspergillosis.
  • Intrapericardial instillation of AMPH-B might be effective for patients with aspergillus pericarditis in whom surgical treatment is not indicated.
  • [MeSH-major] Aspergillosis / etiology. Heart Block / etiology. Lung Diseases, Fungal / etiology. Pericarditis / etiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications


9. Moertel CL, Carlson-Green B, Watterson J, Simonton SC: Lymphomatoid granulomatosis after childhood acute lymphoblastic leukemia: report of effective therapy. Pediatrics; 2001 May;107(5):E82
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  • [Title] Lymphomatoid granulomatosis after childhood acute lymphoblastic leukemia: report of effective therapy.
  • We report a case of lymphomatoid granulomatosis with onset after the completion of chemotherapy for childhood acute lymphoblastic leukemia.
  • Two months after treatment ended, the 7-year-old girl developed splenomegaly, cervical adenopathy, and bilateral interstitial pulmonary infiltrates.
  • A computed tomography scan of the head was normal, but her pulmonary infiltrates had become nodular.
  • A computed tomography-guided biopsy of 1 of the nodules revealed cellular interstitial pneumonitis.
  • Five months after her initial symptoms, she developed tonic pupil and a decreased level of consciousness.
  • Needle biopsies of the brain were carried out, yielding the diagnosis of severe chronic inflammatory changes focally consistent with granuloma.
  • Open-lung biopsy revealed lymphomatoid granulomatosis.
  • Lymphoma-directed therapy was initiated, and the patient had complete resolution of pulmonary and cerebral nodules 5 months later.
  • No intrathecal chemotherapy was administered, and radiation therapy was not necessary.
  • Neuropsychological testing obtained after completion of therapy revealed an improvement in attention, coordination, and fine motor speed over time.
  • [MeSH-major] Brain Neoplasms / diagnosis. Lung Neoplasms / diagnosis. Lymphomatoid Granulomatosis / diagnosis. Neoplasms, Second Primary / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Child, Preschool. Female. Humans. Magnetic Resonance Imaging


10. Nishio H, Sakakibara-Kawamura K, Suzuki T, Utsumi T, Kinoshita S: [An autopsy case of Ph1--positive acute lymphoblastic leukemia with disseminated infection of Fusarium solani]. Kansenshogaku Zasshi; 2002 Jan;76(1):67-71
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  • [Title] [An autopsy case of Ph1--positive acute lymphoblastic leukemia with disseminated infection of Fusarium solani].
  • A 56-year-old woman with Ph1--Positive acute Lymphoblastic Leukemia was admitted to our hospital for induction chemotherapy in June 1999.
  • The patient was presented with a central scotoma of left eye during treatment course and was given diagnosis of endophthalmitis.
  • Thereafter she also developed skin induration and suffered from serious pneumonia.
  • Autopsy was performed, and its specimen revealed the disseminated infection of Fusarium solani (lung, eye, heart, kidney and skin).
  • [MeSH-major] Fusarium. Mycoses / etiology. Philadelphia Chromosome. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications

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  • (PMID = 11852477.001).
  • [ISSN] 0387-5911
  • [Journal-full-title] Kansenshōgaku zasshi. The Journal of the Japanese Association for Infectious Diseases
  • [ISO-abbreviation] Kansenshogaku Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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11. Tatsumoto C, Kawakami K, Nagayama J, Kawano H: [Methotrexate-induced interstitial pneumonitis in a child with acute lymphoblastic leukemia]. Rinsho Ketsueki; 2004 Oct;45(10):1100-4
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  • [Title] [Methotrexate-induced interstitial pneumonitis in a child with acute lymphoblastic leukemia].
  • We report a case of 5-year-old boy with acute lymphoblastic leukemia who developed interstitial pneumonitis induced by methotrexate (MTX).
  • The patient was hospitalized with fever, cough, dyspnea and hypoxemia during maintenance treatment with low dose MTX and 6-mercaptopurine.
  • A diagnosis of MTX pneumonitis was made based on the clinical findings, viral and serologic studies, negative microbiology and the radiological features.
  • The patient recovered after cessation of the MTX treatment.
  • Physicians should be aware of this rare complication during maintenance treatment with weekly low dose MTX for acute lymphoblastic leukemia in children.
  • [MeSH-major] Antimetabolites, Antineoplastic / adverse effects. Lung Diseases, Interstitial / chemically induced. Methotrexate / adverse effects. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy

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  • (PMID = 15553044.001).
  • [ISSN] 0485-1439
  • [Journal-full-title] [Rinshō ketsueki] The Japanese journal of clinical hematology
  • [ISO-abbreviation] Rinsho Ketsueki
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; YL5FZ2Y5U1 / Methotrexate
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12. Salonen JH: Successful management of cerebral and pulmonary mucormycosis with liposomal amphotericin B in a 28-year-old woman with acute lymphoblastic leukemia. Acta Biomed; 2006;77 Suppl 2:28-31
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  • [Title] Successful management of cerebral and pulmonary mucormycosis with liposomal amphotericin B in a 28-year-old woman with acute lymphoblastic leukemia.
  • A 28-year-old woman with acute lymphoblastic leukemia developed fever and unilateral pleural based pulmonary infiltrate during prolonged chemotherapy induced neutropenia.
  • CT-guided lung biopsy confirmed the diagnosis of pulmonary mucormycosis and liposomal amphotericin B therapy was started.
  • A few days after the initial symptoms, the patient developed convulsions and a brain abscess was detected in computerized tomography and magnetic resonance imaging.
  • Fungal hyphae detected in histopathological examination of a brain biopsy had identical morphology with those seen in previous lung biopsies.
  • The patient was treated with liposomal amphotericin B for five months and cytotoxic chemotherapy was successfully completed during antifungal therapy.
  • Antifungal therapy was continued for one additional month after bone marrow transplantation to prevent a relapse of invasive mucormycosis.
  • Follow-up of the patient revealed no signs of relapse of invasive mucormycosis but two months after successful bone marrow transplantation the patient developed lethal cytomegalovirus pneumonitis which was confirmed by autopsy.
  • [MeSH-major] Amphotericin B / therapeutic use. Antifungal Agents / therapeutic use. Brain Abscess / drug therapy. Lung Diseases, Fungal / drug therapy. Mucormycosis / drug therapy
  • [MeSH-minor] 6-Mercaptopurine / administration & dosage. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Asparaginase / administration & dosage. Bone Marrow Transplantation. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Cytarabine / administration & dosage. Cytomegalovirus Infections / complications. Daunorubicin / administration & dosage. Dexamethasone / administration & dosage. Etoposide / administration & dosage. Fatal Outcome. Female. Humans. Immunocompromised Host. Liposomes. Mitoxantrone / administration & dosage. Pneumonia, Viral / complications. Postoperative Complications / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / surgery. Remission Induction. Transplantation, Homologous. Vincristine / administration & dosage

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  • (PMID = 16918065.001).
  • [ISSN] 0392-4203
  • [Journal-full-title] Acta bio-medica : Atenei Parmensis
  • [ISO-abbreviation] Acta Biomed
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antifungal Agents; 0 / Liposomes; 0 / liposomal amphotericin B; 04079A1RDZ / Cytarabine; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 7S5I7G3JQL / Dexamethasone; 7XU7A7DROE / Amphotericin B; 8N3DW7272P / Cyclophosphamide; BZ114NVM5P / Mitoxantrone; E7WED276I5 / 6-Mercaptopurine; EC 3.5.1.1 / Asparaginase; ZS7284E0ZP / Daunorubicin
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13. Kourti M, Vavatsi N, Gombakis N, Sidi V, Tzimagiorgis G, Papageorgiou T, Koliouskas D, Athanassiadou F: Expression of multidrug resistance 1 (MDR1), multidrug resistance-related protein 1 (MRP1), lung resistance protein (LRP), and breast cancer resistance protein (BCRP) genes and clinical outcome in childhood acute lymphoblastic leukemia. Int J Hematol; 2007 Aug;86(2):166-73
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  • [Title] Expression of multidrug resistance 1 (MDR1), multidrug resistance-related protein 1 (MRP1), lung resistance protein (LRP), and breast cancer resistance protein (BCRP) genes and clinical outcome in childhood acute lymphoblastic leukemia.
  • The aim of this prospective study was to analyze the expression of messenger RNA of genes, such as MDR1, MRP1, BCRP, and LRP, implicated in the mechanism of multidrug resistance (MDR) in relation to the response to induction chemotherapy and relapse and these genes' correlation with each other and with pretreatment laboratory and clinical characteristics.
  • We prospectively studied 49 children (26 boys and 23 girls) with acute lymphoblastic leukemia (ALL) (median age, 5.5 years; range, 15 months to 12.5 years) who were treated with the BFM95 chemotherapy protocol.
  • Expression of each of the MDR genes was independent of the initial white blood cell count, immunophenotype, National Cancer Institute risk classification, and prednisone response.
  • Interestingly, MDR1 expression was significantly higher at relapse than at diagnosis for 4 sample pairs.
  • Evaluation of MDR1 expression at diagnosis of childhood ALL may contribute to the early identification of patients at risk of treatment failure.
  • [MeSH-major] ATP-Binding Cassette Transporters / genetics. Drug Resistance, Multiple / genetics. Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics. Vault Ribonucleoprotein Particles / genetics
  • [MeSH-minor] ATP Binding Cassette Transporter, Sub-Family G, Member 2. ATP-Binding Cassette, Sub-Family B, Member 1 / genetics. Antineoplastic Combined Chemotherapy Protocols / pharmacology. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Child. Child, Preschool. Female. Humans. Infant. Male. Multidrug Resistance-Associated Proteins / genetics. Neoplasm Proteins / genetics. Prognosis. Prospective Studies. RNA, Messenger / analysis. Survival Analysis. Treatment Outcome


14. Ishizawa S, Slovak ML, Popplewell L, Bedell V, Wrede JE, Carter NH, Snyder DS, Arber DA: High frequency of pro-B acute lymphoblastic leukemia in adults with secondary leukemia with 11q23 abnormalities. Leukemia; 2003 Jun;17(6):1091-5
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  • [Title] High frequency of pro-B acute lymphoblastic leukemia in adults with secondary leukemia with 11q23 abnormalities.
  • To evaluate the frequency and cytogenetic and immunophenotypic features of therapy-related, precursor B-cell acute lymphoblastic leukemia (ALL), 152 cases of immature B-cell ALL were reviewed.
  • These were compared to the frequency of therapy-related acute myeloid leukemia (t-AML) during the same time period.
  • Eight ALL cases with a prior diagnosis of malignancy were identified, including six (4.0%) with prior therapy considered to be therapy-related ALL (t-ALL).
  • The t-ALL cases followed treatment for breast carcinoma (two cases), lung carcinoma (two cases), lymphocyte predominance Hodgkin's disease and follicular lymphoma with a latency period of 13 months to 8 years.
  • During the same time period, 4.9% of all AML cases were considered t-AML.
  • Despite the similar frequency in therapy-related disease among ALL and AML cases, there were differences in the frequency of the diseases and t-ALL represented 12% of all therapy-related leukemias.
  • However, t-ALL represented 46% of all 11q23-positive therapy-related leukemias.
  • The immunogenetic features of t-ALL appear distinct and may aid in identifying more cases of this disease type in the future.
  • [MeSH-major] Burkitt Lymphoma / etiology. Chromosome Aberrations. Chromosomes, Human, Pair 11 / genetics. Leukemia, Myeloid / etiology. Neoplasms, Second Primary / etiology. Neoplasms, Second Primary / genetics
  • [MeSH-minor] Acute Disease. Adult. Aged. Antigens, CD / immunology. Antineoplastic Agents / therapeutic use. Female. Humans. Immunophenotyping. In Situ Hybridization, Fluorescence. Karyotyping. Male. Middle Aged. Neoplasms / drug therapy. Neoplasms / radiotherapy. Translocation, Genetic

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  • (PMID = 12764373.001).
  • [ISSN] 0887-6924
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA 30206; United States / NCI NIH HHS / CA / CA 33572
  • [Publication-type] Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / Antineoplastic Agents
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15. Ota S, Tanaka J, Kahata K, Toubai T, Kondo K, Mori A, Toyoshima N, Musashi M, Asaka M, Imamura M: Successful micafungin (FK463) treatment of invasive pulmonary aspergillosis in a patient with acute lymphoblastic leukemia in a phase II study. Int J Hematol; 2004 May;79(4):390-3
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  • [Title] Successful micafungin (FK463) treatment of invasive pulmonary aspergillosis in a patient with acute lymphoblastic leukemia in a phase II study.
  • We treated a 52-year-old woman with acute lymphoblastic leukemia (ALL) who developed invasive pulmonary aspergillosis (IPA) as a result of neutropenia following remission-induction chemotherapy.
  • A clinically documented diagnosis of IPA was made on the basis of chest x-rays, computed tomography scan findings, and the detection of Aspergillus DNA.
  • Micafungin was effective for the treatment of IPA in this patient with ALL.
  • [MeSH-major] Aspergillosis / drug therapy. Lipoproteins / therapeutic use. Lung Diseases, Fungal / drug therapy. Peptides, Cyclic / therapeutic use. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • [MeSH-minor] Antineoplastic Agents / adverse effects. Clinical Trials, Phase II as Topic. Echinocandins. Female. Humans. Lipopeptides. Middle Aged. Neutropenia / chemically induced. Neutropenia / complications. Opportunistic Infections / diagnosis. Opportunistic Infections / drug therapy. Treatment Outcome

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  • [Cites] Antimicrob Agents Chemother. 2000 Jan;44(1):57-62 [10602723.001]
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  • (PMID = 15218972.001).
  • [ISSN] 0925-5710
  • [Journal-full-title] International journal of hematology
  • [ISO-abbreviation] Int. J. Hematol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Echinocandins; 0 / Lipopeptides; 0 / Lipoproteins; 0 / Peptides, Cyclic; R10H71BSWG / micafungin
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16. Kudoh T, Suzuki N, Hatakeyama N, Mizue N, Hori T, Oda T, Watanabe J, Imamura M, Chiba S: Successful unrelated cord blood transplantation in Philadelphia chromosome positive acute lymphoblastic leukemia during pulmonary aspergillosis treated by anti-fungal therapy, granulocyte colony-stimulating factor-mobilized granulocytes and surgical resection: case report. Jpn J Clin Oncol; 2001 Jun;31(6):290-3
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  • [Title] Successful unrelated cord blood transplantation in Philadelphia chromosome positive acute lymphoblastic leukemia during pulmonary aspergillosis treated by anti-fungal therapy, granulocyte colony-stimulating factor-mobilized granulocytes and surgical resection: case report.
  • A 3-year-old girl with Philadelphia chromosome positive acute lymphoblastic leukemia developed pulmonary aspergillosis during severe neutropenia by re-induction therapy.
  • She was treated by intravenous fluconazole, oral itraconazole with plasma level monitoring and surgical resection of the focus for 3 months after clinical diagnosis of fungal infection was made.
  • Once she had recovered from surgery we attempted to induce remission with anti-fungal treatment.
  • She developed fever and neutropenia and appeared unlikely to remit with conventional chemotherapy.
  • Unrelated one-antigen-mismatched cord blood (CB) transplantation was performed 2 months after the induction therapy.
  • Anti-fungal drugs were switched to amphotericin B and granulocyte colony-stimulating factor-mobilized granulocyte concentrates were transfused.
  • [MeSH-major] Amphotericin B / administration & dosage. Antifungal Agents / administration & dosage. Aspergillosis / drug therapy. Fetal Blood. Granulocyte Colony-Stimulating Factor / administration & dosage. Hematopoietic Stem Cell Transplantation. Lung Diseases, Fungal / drug therapy. Philadelphia Chromosome. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy


17. Ramakers-van Woerden NL, Pieters R, Hoelzer D, Slater RM, den Boer ML, Loonen AH, Harbott J, Janka-Schaub GE, Ludwig WD, Ossenkoppele GJ, van Wering ER, Veerman AJ, Dutch and German Leukemia Study Groups: In vitro drug resistance profile of Philadelphia positive acute lymphoblastic leukemia is heterogeneous and related to age: a report of the Dutch and German Leukemia Study Groups. Med Pediatr Oncol; 2002 Jun;38(6):379-86
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  • [Title] In vitro drug resistance profile of Philadelphia positive acute lymphoblastic leukemia is heterogeneous and related to age: a report of the Dutch and German Leukemia Study Groups.
  • BACKGROUND: The t(9;22)(q34;q11) translocation leading to the Philadelphia (Ph) chromosome resulting in BCR-ABL gene fusion is associated with a poor prognosis in acute lymphoblastic leukemia (ALL).
  • PROCEDURE: We studied the relation between t(9;22), determined by karyotype, fluorescence in situ hybridization (FISH) or polymerase chain reaction (PCR), and in vitro drug resistance, measured by the MTT assay, in precursor B-cell ALL at diagnosis.
  • Moreover, LC(50) values did not differ significantly between Ph+ and Ph- samples for prednisolone, dexamethasone, L-asparaginase, vincristine, anthracyclines, thiopurines, epipodophyllotoxins, and 4H00-ifosfamide, even after matching for important prognostic features (age, white blood cell count (WBC), and immunophenotype).
  • Adult Ph+ (n = 12) ALL was more resistant to prednisolone (> 270-fold, P = 0.030), and displayed an overall tendency to resistance when compared to matched cases of Ph- (n = 15) adult precursor B-cell ALL.
  • The expression of lung resistance protein (LRP), but not P-glycoprotein (P-gp) or multidrug resistance protein (MRP), was significantly higher in all Ph+ patients.
  • CONCLUSIONS: Both childhood and adult Ph+ precursor B-cell ALL samples display a heterogeneous in vitro resistance profile, with relatively sensitive and resistant cases.
  • [MeSH-major] Drug Resistance, Neoplasm / genetics. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Adult. Antineoplastic Agents / therapeutic use. Child. Drug Screening Assays, Antitumor. Humans. Immunophenotyping. In Vitro Techniques. Leukocyte Count. Multidrug Resistance-Associated Proteins / analysis. Multidrug Resistance-Associated Proteins / genetics. Neoplasm Proteins / analysis. Neoplasm Proteins / genetics. P-Glycoprotein / analysis. P-Glycoprotein / genetics. Philadelphia Chromosome. Prednisolone / therapeutic use. Prognosis. Vault Ribonucleoprotein Particles / genetics

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  • [Copyright] Copyright 2002 Wiley-Liss, Inc.
  • (PMID = 11984797.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Multidrug Resistance-Associated Proteins; 0 / Neoplasm Proteins; 0 / P-Glycoprotein; 0 / Vault Ribonucleoprotein Particles; 0 / major vault protein; 0 / multidrug resistance-associated protein 1; 9PHQ9Y1OLM / Prednisolone
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18. Hayes D Jr: Nosocomial pulmonary Rhizopus diagnosed by bronchoalveolar lavage with cytology in a child with acute lymphoblastic leukemia. Pediatr Hematol Oncol; 2006 Jun;23(4):323-7
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  • [Title] Nosocomial pulmonary Rhizopus diagnosed by bronchoalveolar lavage with cytology in a child with acute lymphoblastic leukemia.
  • Early diagnosis is often difficult but is a necessity to prevent rapid progression of the infection that leads to blood vessel invasion by hyphae, causing fatal hemoptysis.
  • A previous case report described the utility of cytologic examination of bronchoalveolar lavage (BAL) fluid in achieving a prompt diagnosis of Rhizopus species in an adolescent patient with diabetic ketoacidosis.
  • The author presents a case that further describes the benefit of performing BAL fluid cytology to help identify fungal morphology characteristics in order to reach an expeditious diagnosis of Rhizopus species in a leukemia patient.
  • [MeSH-major] Lung Diseases, Parasitic / diagnosis. Mucormycosis / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications. Rhizopus / isolation & purification
  • [MeSH-minor] Amphotericin B / therapeutic use. Bronchoalveolar Lavage. Child. Cross Infection / diagnosis. Cross Infection / parasitology. Drug Combinations. Female. Humans. Phosphatidylcholines / therapeutic use. Phosphatidylglycerols / therapeutic use. Pneumonia / diagnosis. Pneumonia / drug therapy. Pneumonia / parasitology. Tobramycin / therapeutic use

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  • (PMID = 16621774.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Drug Combinations; 0 / Phosphatidylcholines; 0 / Phosphatidylglycerols; 0 / liposomal amphotericin B; 7XU7A7DROE / Amphotericin B; VZ8RRZ51VK / Tobramycin
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19. Yoo JH, Choi JH, Choi SM, Lee DG, Shin WS, Min WS, Kim CC: Application of nucleic acid sequence-based amplification for diagnosis of and monitoring the clinical course of invasive aspergillosis in patients with hematologic diseases. Clin Infect Dis; 2005 Feb 1;40(3):392-8
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  • [Title] Application of nucleic acid sequence-based amplification for diagnosis of and monitoring the clinical course of invasive aspergillosis in patients with hematologic diseases.
  • BACKGROUND AND METHODS: We evaluated nucleic acid sequence-based amplification (NASBA) and a galactomannan enzyme immunosorbent assay (GM-EIA) for the diagnosis of invasive aspergillosis (IA) in neutropenic febrile patients and for monitoring of its clinical course and outcome.
  • Blood samples were collected twice per week from 128 patients with hematologic diseases during periods of neutropenic fever after undergoing chemotherapy or hematopoietic stem cell transplantation.
  • In receiver-operator characteristic analysis, the cutoff index of NASBA for the presumptive diagnosis of IA was determined to be 5.0.
  • Combination of these 2 parameters (either a GM-EIA index of >or=0.5 or a NASBA index of >or=5.0) improved the sensitivity of diagnosis to 100%.
  • There was a close relationship between patient outcome and the kinetics of NASBA values: failure of negative conversion during treatment resulted in death in almost all cases.
  • CONCLUSION: If either GM-EIA or NASBA results suggest IA, the diagnostic yield for IA could be improved, and NASBA could be a useful marker for predicting the clinical course and outcome of treatment.
  • [MeSH-major] Aspergillosis / complications. Aspergillosis / diagnosis. Hematologic Diseases / complications. Immunoenzyme Techniques / methods. Mannans / analysis. Nucleic Acid Amplification Techniques / methods
  • [MeSH-minor] Adult. Aged. Antifungal Agents / therapeutic use. Female. Humans. Leukemia, Myeloid, Acute / complications. Lung Diseases, Fungal / complications. Lung Diseases, Fungal / diagnosis. Lung Diseases, Fungal / drug therapy. Lung Diseases, Fungal / microbiology. Male. Middle Aged. Myelodysplastic Syndromes / complications. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications. Sensitivity and Specificity

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  • (PMID = 15668862.001).
  • [ISSN] 1537-6591
  • [Journal-full-title] Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
  • [ISO-abbreviation] Clin. Infect. Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antifungal Agents; 0 / Mannans; 11078-30-1 / galactomannan
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20. Slavin MA, Kannan K, Buchanan MR, Sasadeusz J, Roberts AW: Successful allogeneic stem cell transplant after invasive pulmonary zygomycosis. Leuk Lymphoma; 2002 Feb;43(2):437-9
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  • [Title] Successful allogeneic stem cell transplant after invasive pulmonary zygomycosis.
  • We report the successful outcome of allogeneic stem cell transplant (SCT) in a patient with acute lymphoblastic leukaemia (ALL) and pulmonary zygomycosis diagnosed prior to transplant.
  • The lesion was surgically excised and SCT proceeded with antifungal therapy, granulocyte transfusions and G-CSF support during the period of neutropenia.
  • [MeSH-major] Lung Diseases, Fungal / chemically induced. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy. Stem Cell Transplantation. Zygomycosis / chemically induced
  • [MeSH-minor] Adult. Amphotericin B / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / toxicity. Disease-Free Survival. Humans. Male. Opportunistic Infections / chemically induced. Opportunistic Infections / diagnosis. Opportunistic Infections / drug therapy. Remission Induction. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 11999584.001).
  • [ISSN] 1042-8194
  • [Journal-full-title] Leukemia & lymphoma
  • [ISO-abbreviation] Leuk. Lymphoma
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 7XU7A7DROE / Amphotericin B
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21. Kanra G, Cetin I, Akçören Z, Cağlar M, Cengiz AB, Baykan A, Kara A: Giant cell pneumonia in a leukemic child in remission: a case report. Turk J Pediatr; 2001 Oct-Dec;43(4):338-41
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  • [Title] Giant cell pneumonia in a leukemic child in remission: a case report.
  • Giant cell pneumonia is a rare and uncommon type of lung infection developing as a complication of measles, especially in immunocompromised patients, whether their immune systems are affected primarily or whether they have acquired immune defects.
  • We report a case with giant cell pneumonia that was confirmed by postmortem histopathological examination.
  • We especially want to point out that even in the absence of rash, with the clinical and radiological features of pneumonia, measles should be considered in a patient, whether in remission or not, receiving immunosuppressive treatment.
  • [MeSH-major] Giant Cells / pathology. Immunocompromised Host. Measles / diagnosis. Pneumonia, Viral / diagnosis
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Autopsy. Child. Diagnosis, Differential. Fatal Outcome. Female. Humans. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Remission Induction

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  • (PMID = 11765166.001).
  • [ISSN] 0041-4301
  • [Journal-full-title] The Turkish journal of pediatrics
  • [ISO-abbreviation] Turk. J. Pediatr.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Turkey
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22. Pagano L, Fianchi L, Mele L, Girmenia C, Offidani M, Ricci P, Mitra ME, Picardi M, Caramatti C, Piccaluga P, Nosari A, Buelli M, Allione B, Cortelezzi A, Fabbiano F, Milone G, Invernizzi R, Martino B, Masini L, Todeschini G, Cappucci MA, Russo D, Corvatta L, Martino P, Del Favero A: Pneumocystis carinii pneumonia in patients with malignant haematological diseases: 10 years' experience of infection in GIMEMA centres. Br J Haematol; 2002 May;117(2):379-86
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  • The study included 55 patients (18 with non-Hodgkin's lymphoma, 10 with acute lymphoblastic leukaemia, eight with acute myeloid leukaemia, five with chronic myeloid leukaemia, four with chronic lymphocytic leukaemia, four with multiple myeloma, three with myelodysplastic syndrome, two with myelofibrosis and one with thalassemia) who developed PCP.
  • Among these, 18 (33%) underwent stem cell transplantation; only two received an oral prophylaxis with trimethroprim/sulphamethoxazole.
  • Twelve patients (22%) developed PCP despite protective isolation in a laminar airflow room.
  • Chest radiography or computerized tomography showed interstitial infiltrates in 34 patients (62%), alveolar infiltrates in 12 patients (22%), and alveolar-interstitial infiltrates in nine patients (16%).
  • Bronchoalveolar lavage was diagnostic in 47/48 patients, induced sputum in 9/18 patients and lung biopsy in 3/8 patients.
  • The diagnosis was made in two patients at autopsy.
  • All patients except one started a specific treatment (52 patients trimethroprim/sulphamethoxazole, one pentamidine and one dapsone).
  • Sixteen patients (29%) died of PCP within 30 d of diagnosis.
  • Multivariate analysis showed that prolonged steroid treatment (P < 0.006) and a radiological picture of diffuse lung involvement (P < 0.003) were negative diagnostic factors.
  • [MeSH-minor] Acute Disease. Adolescent. Adult. Aged. Anti-Infective Agents / therapeutic use. Bronchoalveolar Lavage Fluid / microbiology. Female. Humans. Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy. Leukemia, Lymphocytic, Chronic, B-Cell / microbiology. Leukemia, Lymphocytic, Chronic, B-Cell / mortality. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / microbiology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / mortality. Leukemia, Myeloid / drug therapy. Leukemia, Myeloid / microbiology. Leukemia, Myeloid / mortality. Lung / radiography. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / microbiology. Lymphoma, Non-Hodgkin / mortality. Male. Middle Aged. Multiple Myeloma / drug therapy. Multiple Myeloma / microbiology. Multiple Myeloma / mortality. Multivariate Analysis. Myelodysplastic Syndromes / drug therapy. Myelodysplastic Syndromes / microbiology. Myelodysplastic Syndromes / mortality. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / microbiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality. Primary Myelofibrosis / drug therapy. Primary Myelofibrosis / microbiology. Primary Myelofibrosis / mortality. Retrospective Studies. Thalassemia / drug therapy. Thalassemia / microbiology. Thalassemia / mortality. Treatment Outcome. Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use

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  • (PMID = 11972521.001).
  • [ISSN] 0007-1048
  • [Journal-full-title] British journal of haematology
  • [ISO-abbreviation] Br. J. Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Anti-Infective Agents; 8064-90-2 / Trimethoprim, Sulfamethoxazole Drug Combination
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23. Celkan T, Berrak S, Kazanci E, Ozyürek E, Unal S, Uçar C, Yilmaz S, Gürgey A: Malignancy-associated hemophagocytic lymphohistiocytosis in pediatric cases: a multicenter study from Turkey. Turk J Pediatr; 2009 May-Jun;51(3):207-13
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  • The diagnosis of HLH had been established by bone marrow aspiration in 27 patients, cerebrospinal fluid and bone marrow aspiration in one patient and lung-liver biopsy in another.
  • Five patients with acute leukemia had HLH at the time of diagnosis (Group 1a), and 15 patients with acute leukemia were diagnosed as having sHLH during therapy (Group 1b), namely reactive sHLH associated with the chemotherapy.
  • Nine patients, including two cases each of rhabdomyosarcoma, neuroblastoma, Hodgkin disease, and non-Hodgkin lymphoma (NHL) and one case with Langerhans cell histiocytosis, were diagnosed as having concomitant hemophagocytosis at the initial evaluation of the tumor (Group 2).
  • [MeSH-major] Leukemia, Myeloid, Acute / complications. Lymphohistiocytosis, Hemophagocytic / diagnosis. Lymphohistiocytosis, Hemophagocytic / etiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications


24. Imberti D, Vallisa D, Anselmi E, Moroni CF, Bertè R, Lazzaro A, Bernuzzi P, Arcari AL, Cavanna L: Safety and efficacy of enoxaparin treatment in venous thromboembolic disease during acute leukemia. Tumori; 2004 Jul-Aug;90(4):390-3
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  • [Title] Safety and efficacy of enoxaparin treatment in venous thromboembolic disease during acute leukemia.
  • The best treatment of this complication is still a matter of debate due to the very high risk of hemorrhage in this group of patients.
  • PATIENTS AND METHODS: From December 2000 to December 2002 four Caucasian patients with acute leukemia developed VTE complications.
  • Two patients with acute lymphoid leukemia (L1 and L2 according to the FAB classification) developed deep venous thrombosis during the administration of chemotherapy; one patient with acute myeloid leukemia (AML, M2 according to the FAB classification) had pulmonary thromboembolism at diagnosis, while another AML patient (M4 according to FAB) showed deep venous thrombosis as the first symptom of leukemia.
  • The clinical diagnosis of symptomatic VTE was confirmed by objective imaging procedures including lower limb venous color Doppler imaging in all cases and a ventilation-perfusion lung scan in one case.
  • RESULTS: During antithrombotic treatment neither VTE recurrences nor hemorrhagic complications or heparin-induced thrombocytopenia occurred.
  • The platelet count at the beginning of enoxaparin treatment was very low (mean, 55,750 x 109/L; range, 12,000-121,000 x 10(9)/L) and treatment did not affect platelet recovery.
  • [MeSH-major] Anticoagulants / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Enoxaparin / therapeutic use. Leukemia, Myeloid, Acute / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Thromboembolism / drug therapy. Venous Thrombosis / drug therapy
  • [MeSH-minor] Adult. Aged. Female. Fibrinolytic Agents / therapeutic use. Hemorrhage / chemically induced. Humans. Male. Middle Aged. Platelet Count. Retrospective Studies. Thrombocytopenia / chemically induced. Time Factors. Treatment Outcome

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  • (PMID = 15510981.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anticoagulants; 0 / Enoxaparin; 0 / Fibrinolytic Agents
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25. Herbrecht R, Letscher-Bru V, Fohrer C, Campos F, Natarajan-Ame S, Zamfir A, Waller J: Acremonium strictum pulmonary infection in a leukemic patient successfully treated with posaconazole after failure of amphotericin B. Eur J Clin Microbiol Infect Dis; 2002 Nov;21(11):814-7
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  • A severely neutropenic patient with chronic lymphocytic leukemia developed a diffuse bilateral pulmonary infection while receiving a therapeutic daily dosage of intravenous amphotericin B for Candida glabrata esophagitis.
  • Computed tomography of the chest showed numerous lung nodules, ground glass areas and a pleural effusion.
  • Change of treatment to posaconazole given orally at 200 mg four times/d resulted in progressive improvement leading finally to cure after 24 weeks of therapy.
  • Treatment with posaconazole was clinically and biologically well tolerated.
  • [MeSH-major] Acremonium / drug effects. Acremonium / isolation & purification. Amphotericin B / administration & dosage. Immunocompromised Host. Lung Diseases, Fungal / diagnosis. Lung Diseases, Fungal / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology. Triazoles / administration & dosage
  • [MeSH-minor] Administration, Oral. Antifungal Agents / administration & dosage. Biopsy, Needle. Female. Follow-Up Studies. Humans. Microbial Sensitivity Tests. Middle Aged. Risk Assessment. Tomography, X-Ray Computed. Treatment Failure. Treatment Outcome

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  • (PMID = 12461592.001).
  • [ISSN] 0934-9723
  • [Journal-full-title] European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
  • [ISO-abbreviation] Eur. J. Clin. Microbiol. Infect. Dis.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antifungal Agents; 0 / Triazoles; 6TK1G07BHZ / posaconazole; 7XU7A7DROE / Amphotericin B
  • [Number-of-references] 15
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26. Furuya ME, González-Martínez F, Vargas MH, Miranda-Novales MG, Bernáldez-Ríos R, Zúñiga-Vázquez G: Guidelines for diagnosing and treating pulmonary infiltrates in children with acute leukaemia: impact of timely decisions. Acta Paediatr; 2008 Jul;97(7):928-34
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  • AIM: Children with leukaemia are at increased risk of pulmonary complications, often with unspecific clinical data, delayed diagnosis and a high mortality rate.
  • We evaluated the usefulness of diagnostic-therapeutic guidelines (DTG) in which specific times for decision making were incorporated.
  • Patients were allocated to group I if their diagnostic and therapeutic decisions were in accordance with the DTG, and to group II if not.
  • RESULTS: Children from group I (n=32) and group II (n=28) did not differ with respect to age (9.3+/-0.5 years old, mean+/-SEM), gender, type, risk and stage of leukaemia, anaemia and neutropenia.
  • CONCLUSIONS: Diagnostic-therapeutic guidelines that incorporate timely decisions constitute a useful algorithm to reduce the length of hospital stay and mortality in children with acute leukaemia and pulmonary infiltrates.
  • [MeSH-major] Leukemia, Myeloid, Acute / complications. Lung Diseases / diagnosis. Lung Diseases / therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications

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  • (PMID = 18430068.001).
  • [ISSN] 0803-5253
  • [Journal-full-title] Acta paediatrica (Oslo, Norway : 1992)
  • [ISO-abbreviation] Acta Paediatr.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Norway
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27. Adderson EE: Histoplasmosis in a pediatric oncology center. J Pediatr; 2004 Jan;144(1):100-6
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  • The most rapid and specific tests for histoplasmosis in patients with cancer were histopathologic examination of lung biopsy specimens in patients with localized pulmonary infection and Histoplasma sp. antigen detection in the urine of patients with disseminated histoplasmosis (DH).
  • The mean times to diagnosis were 20.6+/-15.2 days (pulmonary) and 18.6+/-8.2 days (disseminated) after the onset of symptoms.
  • Most patients were treated with amphotericin B (AmB) followed by azole drugs for a mean of 8.5+/-3.1 weeks (pulmonary) and 10.4+/-7.9 weeks (disseminated).
  • No patient died of histoplasmosis, but cancer therapy often was modified because of the infection.
  • Most received unnecessary antibacterial drugs.
  • Delay in diagnosis of histoplasmosis complicates care.
  • No deaths were attributed to histoplasmosis; outcomes after treatment are good.
  • [MeSH-major] Histoplasmosis / diagnosis
  • [MeSH-minor] Acute Disease. Adolescent. Adult. Amphotericin B / therapeutic use. Antifungal Agents / therapeutic use. Child. Female. Humans. Lung Diseases, Fungal / complications. Lung Diseases, Fungal / diagnosis. Lung Diseases, Fungal / drug therapy. Male. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications. Retrospective Studies

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  • (PMID = 14722526.001).
  • [ISSN] 0022-3476
  • [Journal-full-title] The Journal of pediatrics
  • [ISO-abbreviation] J. Pediatr.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA21765
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antifungal Agents; 7XU7A7DROE / Amphotericin B
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28. Gottfredsson M, Steingrímsdóttir H: Disseminated invasive aspergillosis in a patient with acute leukaemia. Acta Biomed; 2006;77 Suppl 2:10-3
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  • A 46-year-old previously healthy woman was diagnosed with acute lymphoblastic leukaemia.
  • The induction phase was complicated by alpha-haemolytic streptococcal bacteremia which responded to antibacterial therapy.
  • Subsequently, the patient developed pneumonie due to Chlamydiapneumoniae which responded to macrolides.
  • Following this infection the patient developed recurrent fever and new pulmonary infiltrates were noted.
  • Bronchoscopy was performed and treatment was administered with liposomal amphotericin B (L-AmB, AmBisome) for two days, but was complicated by acute renal failure.
  • Despite aggressive antifungal therapy the patient developed progressive invasive infection, with central nervous system involvement as well as lesions appearing in the kidneys and liver.
  • The patient died one week following the diagnosis of aspergillosis.
  • [MeSH-major] Amphotericin B / therapeutic use. Antifungal Agents / therapeutic use. Aspergillosis / complications. Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / complications
  • [MeSH-minor] Acute Kidney Injury / chemically induced. Anti-Bacterial Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bacteremia / complications. Bacteremia / drug therapy. Chlamydophila Infections / complications. Chlamydophila Infections / drug therapy. Chlamydophila pneumoniae. Doxorubicin / administration & dosage. Drug Resistance, Multiple, Fungal. Drug Therapy, Combination. Echinocandins. Fatal Outcome. Female. Humans. Immunocompromised Host. Liposomes. Lung Diseases, Fungal / complications. Lung Diseases, Fungal / drug therapy. Medical Futility. Methotrexate / administration & dosage. Middle Aged. Neuroaspergillosis / drug therapy. Neuroaspergillosis / etiology. Peptides, Cyclic / administration & dosage. Peptides, Cyclic / therapeutic use. Pneumonia, Bacterial / complications. Pyrimidines / therapeutic use. Streptococcal Infections / complications. Streptococcal Infections / drug therapy. Triazoles / therapeutic use. Vincristine / administration & dosage. Voriconazole

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  • [ErratumIn] Acta Biomed. 2006;77 Suppl 4:following 33
  • (PMID = 16918060.001).
  • [ISSN] 0392-4203
  • [Journal-full-title] Acta bio-medica : Atenei Parmensis
  • [ISO-abbreviation] Acta Biomed
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents; 0 / Antifungal Agents; 0 / Echinocandins; 0 / Liposomes; 0 / Peptides, Cyclic; 0 / Pyrimidines; 0 / Triazoles; 0 / liposomal amphotericin B; 5J49Q6B70F / Vincristine; 7XU7A7DROE / Amphotericin B; 80168379AG / Doxorubicin; F0XDI6ZL63 / caspofungin; JFU09I87TR / Voriconazole; YL5FZ2Y5U1 / Methotrexate
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29. Gulen H, Erbay A, Gulen F, Kazanci E, Vergin C, Demir E, Tanac R: Sinopulmonary aspergillosis in children with hematological malignancy. Minerva Pediatr; 2006 Jun;58(3):319-24
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  • Despite improvements in early diagnosis and effective treatment, invasive pulmonary aspergillosis is still a devastating opportunistic infection.
  • These infections also interfere with the anticancer treatment.
  • We report our experience in the diagnosis and therapeutic management of sinopulmonary aspergillosis in 4 children with hematologic malignancy.
  • Radiodiagnostic methods showed bilateral multiple nodular infiltrations, soft tissue densities filling all the paranasal sinuses, and bronchiectasis.
  • Diagnosis of aspergillosis was established by bronchoalveolar lavage in one case, tissue biopsy, positive sputum and positive cytology, respectively, in the other 3 cases.
  • Early diagnosis, appropriate treatment and primary disease status are important factors on prognosis of Aspergillus infections in children with hematological malignancy.
  • [MeSH-major] Aspergillosis. Burkitt Lymphoma / complications. Leukemia, Myeloid / complications. Lung Diseases, Fungal. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • [MeSH-minor] Acute Disease. Adolescent. Amphotericin B / administration & dosage. Amphotericin B / therapeutic use. Antifungal Agents / administration & dosage. Antifungal Agents / therapeutic use. Child. Drug Therapy, Combination. Female. Humans. Immunocompromised Host. Itraconazole / administration & dosage. Itraconazole / therapeutic use. Male. Prognosis. Radiography, Thoracic. Time Factors. Tomography, X-Ray Computed

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  • (PMID = 16832339.001).
  • [ISSN] 0026-4946
  • [Journal-full-title] Minerva pediatrica
  • [ISO-abbreviation] Minerva Pediatr.
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Antifungal Agents; 304NUG5GF4 / Itraconazole; 7XU7A7DROE / Amphotericin B
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