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Neutropenia Causes

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1. Early discontinuation of antibiotics for febrile neutropenia versus continuation until neutropenia resolution in people with cancer. (PubMed)

regardless of the neutrophil count to a long course in which antibiotics were continued until neutropenia resolution in people with cancer with febrile neutropenia. The primary outcome was 30-day or end of follow-up all-cause mortality.Two review authors independently reviewed all studies for eligibility, extracted data, and assessed risk of bias for all included trials. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) whenever possible. For dichotomous outcomes with zero events (...) Early discontinuation of antibiotics for febrile neutropenia versus continuation until neutropenia resolution in people with cancer. People with cancer with febrile neutropenia are at risk of severe infections and mortality and are thus treated empirically with broad-spectrum antibiotic therapy. However, the recommended duration of antibiotic therapy differs across guidelines.To assess the safety of protocol-guided discontinuation of antibiotics regardless of neutrophil count, compared

2019 Cochrane

2. Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia. (PubMed)

Low bacterial diet versus control diet to prevent infection in cancer patients treated with chemotherapy causing episodes of neutropenia. Neutropenia is a potentially serious side effect of chemotherapy and a major risk factor for infection, which can be life-threatening. It has been hypothesised that a low bacterial diet (LBD) can prevent infection and (infection-related) mortality in cancer patients receiving chemotherapy that causes episodes of neutropenia, but much remains unclear (...) . This review is an update of a previously published Cochrane review.The primary objective of this review was to determine the efficacy of an LBD versus a control diet in preventing infection and in decreasing (infection-related) mortality in adult and paediatric cancer patients receiving chemotherapy that causes episodes of neutropenia. Secondary objectives were to assess time to first febrile episode, need for empirical antibiotic therapy, diet acceptability and quality of life.We searched the following

2016 Cochrane

3. Loss of mDia1 causes neutropenia via attenuated CD11b endocytosis and increased neutrophil adhesion to the endothelium (PubMed)

Loss of mDia1 causes neutropenia via attenuated CD11b endocytosis and increased neutrophil adhesion to the endothelium Formin protein mDia1 is involved in actin polymerization and plays important roles in the migration and adhesion of hematopoietic cells. The mDia1 encoding gene is located on chromosome 5q, which is commonly deleted in patients with del(5q) myelodysplastic syndromes (MDSs). We previously reported that mice with mDia1 deficiency developed neutropenia that closely mimics MDS (...) . However, the mechanism of neutropenia in these mice and patients with del(5q) MDS remains incompletely defined. Here, we reveal that mDia1 knockout mice show cell-autonomously increased CD11b expression on neutrophils in the peripheral blood and bone marrow. The level of CD11b was also higher in patients with del(5q) MDS compared with normal individuals. Mechanistically, loss of mDia1 significantly attenuated the endocytosis of CD11b on neutrophils, which led to an increased number of neutrophils

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2017 Blood advances

4. Juvenile ecthyma gangrenosum caused by Pseudomonas aeruginosa revealing an underlying neutropenia: case report and review of the literature. (PubMed)

Juvenile ecthyma gangrenosum caused by Pseudomonas aeruginosa revealing an underlying neutropenia: case report and review of the literature. Ecthyma gangrenosum (EG) is characterized by the occurrence of erythematous, violaceous or haemorrhagic macules and/or vesicles, often evolving into necrotic ulcers, with a central grey-black eschar. It is a rare skin condition, usually occurring in immunocompromised patients suffering from bacterial sepsis caused by Pseudomonas aeruginosa. However (...) , seemingly healthy children have been diagnosed with this skin disease as well.We report the workup of a case of vulvar EG caused by P. aeruginosa in a toddler, which led to a diagnosis of an underlying neutropenia. Moreover, we provide a brief literature review on those cases of EG where an underlying primary immunodeficiency, neutropenia in particular, was eventually diagnosed.A one-and-a-half-year-old girl presented with a history of recurrent (respiratory) infections and the sporadic occurrence

2019 Journal of the European Academy of Dermatology and Venereology

5. Risk factors for extended-spectrum beta-lactamase-producing Enterobacteriaceae infection causing septic shock in cancer patients with chemotherapy-induced febrile neutropenia. (PubMed)

Risk factors for extended-spectrum beta-lactamase-producing Enterobacteriaceae infection causing septic shock in cancer patients with chemotherapy-induced febrile neutropenia. Patients with chemotherapy-induced febrile neutropenia (FN) are vulnerable to extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBL-PE) infection. Early identification of patients suspected to have ESBL-PE infection for empirical carbapenem administration is crucial; nevertheless, risk factors for ESBL-PE (...) causing septic shock remain unclear. We identify factors to predict ESBL-PE in septic shock patients with chemotherapy-induced FN. In this observational, prospectively collected registry-based study, consecutive adult chemotherapy-induced FN patients with septic shock who were admitted to the emergency department between June 2012 and June 2018 were enrolled. Clinical and laboratory data extracted from the septic shock registry were assessed to identify risk factors for ESBL-PE. Of 179 chemotherapy

2019 Internal and emergency medicine

6. Functional characteristics of circulating granulocytes in severe congenital neutropenia caused by ELANE mutations. (PubMed)

Functional characteristics of circulating granulocytes in severe congenital neutropenia caused by ELANE mutations. Neutrophils and eosinophils are multifunctional granulocytes derived from common myelocytic-committed progenitor cells. Severe congenital neutropenia 1 (SCN1) caused by ELANE mutations is a rare disease characterized by very low numbers of circulating neutrophils. Little is known about the functional characteristics of the SCN1 granulocytes, except that eosinophilia has been (...) neutrophils.SCN1 patients with ELANE mutations suffer from neutropenia yet display eosinophilia in the bone marrow and blood, as revealed by smear examination but not by automatic blood analysers. The SCN1 eosinophils are functionally normal regarding production of reactive oxygen species (ROS). However, the ROS profile produced by eosinophils differs drastically from that of neutrophils isolated from the same blood donor, implying that the eosinophilia in SCN1 cannot compensate for the loss of neutrophils

2019 BMC Pediatrics

7. Febrile neutropenia

of cancer therapy and is an oncological emergency. Empirical antibiotic therapy upon presentation has dramatically improved outcomes and decreased mortality from febrile neutropenia. A causative organism is only identified one third of the time, and therefore antibiotics are aimed at treating a broad spectrum of pathogens. Due to an inability to mount an inflammatory response, many patients with febrile neutropenia do not demonstrate localising signs or symptoms other than fever. Prophylactic (...) Febrile neutropenia Febrile neutropenia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Febrile neutropenia Last reviewed: February 2019 Last updated: October 2018 Summary Defined as a fever >38°C (>101°F) for 1 hour, with an absolute neutrophil count (ANC) of ≤500 cells/microlitre, or an ANC ≤1000 cells/microlitre with a projected nadir of ≤500 cells/microlitre. It is the most common life-threatening complication

2018 BMJ Best Practice

8. Febrile neutropenia

of cancer therapy and is an oncological emergency. Empirical antibiotic therapy upon presentation has dramatically improved outcomes and decreased mortality from febrile neutropenia. A causative organism is only identified one third of the time, and therefore antibiotics are aimed at treating a broad spectrum of pathogens. Due to an inability to mount an inflammatory response, many patients with febrile neutropenia do not demonstrate localising signs or symptoms other than fever. Prophylactic (...) Febrile neutropenia Febrile neutropenia - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Febrile neutropenia Last reviewed: February 2019 Last updated: October 2018 Summary Defined as a fever >38°C (>101°F) for 1 hour, with an absolute neutrophil count (ANC) of ≤500 cells/microlitre, or an ANC ≤1000 cells/microlitre with a projected nadir of ≤500 cells/microlitre. It is the most common life-threatening complication

2018 BMJ Best Practice

9. Assessment of neutropenia

from decreased production, accelerated utilisation, increased destruction, or a shift in compartments. A combination of these mechanisms may be present. Causes can be congenital or acquired. The most serious complication of neutropenia is infection, which can be fatal. The source is usually endogenous flora of the gut and mucosa (commonly Staphylococcus and gram-negative organisms). Fungal infections occur with increased frequency, but there is no increased risk of viral or parasitic infection (...) ://www.ncbi.nlm.nih.gov/pubmed/3181399?tool=bestpractice.com The normal range in black people has a lower limit of 1400/microlitre or 1.4 x 10^9/L. Common causes Infections are the most common causes of neutropenia in adults, followed by drug-induced neutropenias. Andres E, Federici L, Weitten T, et al. Recognition and management of drug-induced blood cytopenias: the example of drug-induced acute neutropenia and agranulocytosis. Expert Opin Drug Saf. 2008 Jul;7(4):481-9. http://www.ncbi.nlm.nih.gov/pubmed/18613811

2018 BMJ Best Practice

10. Chronic Neutropenia in Children with Abscess Forming Cervical Lymphadenitis Caused by Staphylococcus aureus. (PubMed)

Chronic Neutropenia in Children with Abscess Forming Cervical Lymphadenitis Caused by Staphylococcus aureus. Suppurative cervical lymphadenitis is rare in children with limited information about the frequency of neutropenia in any series.We conducted a retrospective review of pediatric patients in whom suppurative cervical lymphadenitis was diagnosed between April 2011 and March 2016 at a tertiary children's hospital in Tokyo, Japan. Microbiologically confirmed cases of cervical lymphadenitis (...) with abscess formation were included in the analysis.Twenty-five patients (median age, 1 yr old; 64% female) with abscess formation caused by Staphylococcus aureus were identified. Among these 25 patients, 5 (20%) met the criteria for chronic neutropenia and 4 (80%) received the final diagnosis of autoimmune neutropenia based on the identification of the serum anti-CD16 antibodies.Chronic neutropenia and autoimmune neutropenia were relatively common among infants with suppurative cervical lymphadenitis

2018 Pediatric Infectious Dsease Journal

11. Mutations in <i>SRP54</i> gene cause severe congenital neutropenia as well as Shwachman-Diamond-like syndrome. (PubMed)

Mutations in SRP54 gene cause severe congenital neutropenia as well as Shwachman-Diamond-like syndrome. Congenital neutropenias (CNs) are rare heterogeneous genetic disorders, with about 25% of patients without known genetic defects. Using whole-exome sequencing, we identified a heterozygous mutation in the SRP54 gene, encoding the signal recognition particle (SRP) 54 GTPase protein, in 3 sporadic cases and 1 autosomal dominant family. We subsequently sequenced the SRP54 gene in 66 (...) probands from the French CN registry. In total, we identified 23 mutated cases (16 sporadic, 7 familial) with 7 distinct germ line SRP54 mutations including a recurrent in-frame deletion (Thr117del) in 14 cases. In nearly all patients, neutropenia was chronic and profound with promyelocytic maturation arrest, occurring within the first months of life, and required long-term granulocyte colony-stimulating factor therapy with a poor response. Neutropenia was sometimes associated with a severe

2018 Blood

12. Neutropenia caused by hairy cell leukemia in a patient with myelofibrosis secondary to polycythemia vera: a case report (PubMed)

Neutropenia caused by hairy cell leukemia in a patient with myelofibrosis secondary to polycythemia vera: a case report Polycythemia vera is a myeloproliferative disease that sometimes evolves to myelofibrosis, causing splenomegaly and neutropenia. In this case report, we describe a patient with polycythemia vera and unexplained neutropenia who later turned out to also have hairy cell leukemia.A middle-aged Caucasian man with polycythemia vera presented to our hospital with chronic mouth ulcers

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2018 Journal of medical case reports

13. Mutations in signal recognition particle SRP54 cause syndromic neutropenia with Shwachman-Diamond–like features (PubMed)

Mutations in signal recognition particle SRP54 cause syndromic neutropenia with Shwachman-Diamond–like features Shwachman-Diamond syndrome (SDS) (OMIM #260400) is a rare inherited bone marrow failure syndrome (IBMFS) that is primarily characterized by neutropenia and exocrine pancreatic insufficiency. Seventy-five to ninety percent of patients have compound heterozygous loss-of-function mutations in the Shwachman-Bodian-Diamond syndrome (sbds) gene. Using trio whole-exome sequencing (WES (...) ) in an sbds-negative SDS family and candidate gene sequencing in additional SBDS-negative SDS cases or molecularly undiagnosed IBMFS cases, we identified 3 independent patients, each of whom carried a de novo missense variant in srp54 (encoding signal recognition particle 54 kDa). These 3 patients shared congenital neutropenia linked with various other SDS phenotypes. 3D protein modeling revealed that the 3 variants affect highly conserved amino acids within the GTPase domain of the protein

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2017 The Journal of clinical investigation

14. A rare case of lung carcinoma acquires multidrug-resistant Klebsiella pneumoniae pneumonia radiologically mimicking metastasis caused by nivolumab therapy-associated neutropenia (PubMed)

A rare case of lung carcinoma acquires multidrug-resistant Klebsiella pneumoniae pneumonia radiologically mimicking metastasis caused by nivolumab therapy-associated neutropenia Nosocomial infections by Klebsiella pneumoniae, especially those due to multidrug-resistant strains, are being increasingly detected. In this report, we present the case of a 63-year-old man with lung squamous carcinoma who received nivolumab therapy due to failure of first-line chemotherapy. This report also (...) demonstrates an association of nivolumab therapy and neutropenia, and supports the use of a combination of tigecycline and meropenem in managing hospitalization-acquired pneumonia caused by multidrug-resistant K. pneumoniae. It also implicates that a further evaluation is required in lung cancer patients with a suspected metastatic or recurrent carcinoma, and an antibiotic therapy is valuable in ruling out a potential lung infection since a risk of hospitalization-acquired pneumonia may exist.

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2017 Therapeutics and clinical risk management

15. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2017.77.6211 Journal of Clinical (...) Oncology - published online before print February 20, 2018 PMID: Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update x Randy A. Taplitz , x Erin B. Kennedy , x Eric J. Bow , x Jennie Crews , x Charise Gleason , x Douglas K. Hawley , x Amelia A. Langston , x Loretta J. Nastoupil , x Michelle Rajotte , x Kenneth Rolston , x Lynne Strasfeld , and x Christopher R

2018 American Society of Clinical Oncology Guidelines

16. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update | Journal of Clinical Oncology Search in: Menu Article Tools ASCO SPECIAL ARTICLE Article Tools OPTIONS & TOOLS COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2017.77.6211 Journal of Clinical (...) Oncology - published online before print February 20, 2018 PMID: Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update x Randy A. Taplitz , x Erin B. Kennedy , x Eric J. Bow , x Jennie Crews , x Charise Gleason , x Douglas K. Hawley , x Amelia A. Langston , x Loretta J. Nastoupil , x Michelle Rajotte , x Kenneth Rolston , x Lynne Strasfeld , and x Christopher R

2018 Infectious Diseases Society of America

17. Very early discharge versus early discharge versus non-early discharge in children with cancer and febrile neutropenia. (PubMed)

Very early discharge versus early discharge versus non-early discharge in children with cancer and febrile neutropenia. Chemotherapy-induced neutropenia is a common adverse effect in children with cancer. Due to the high relative risk of infections and infectious complications, standard care for children with cancer and febrile neutropenia consists of routine hospitalization and parenteral administration of broad-spectrum antibiotics. However, there are less serious causes of febrile (...) neutropenia; in a subgroup of these children, lengthy in-hospital treatment might be unnecessary. Various research groups have studied the adjustment of standard care to shorten in-hospital treatment for children with cancer and febrile neutropenia at low risk for bacterial infections. However, most of these studies were not done in a randomized matter.To evaluate whether early discharge (mean/median of less than five days) from in-hospital treatment was not inferior to non-early discharge (mean/median

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2016 Cochrane

18. Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction. (PubMed)

Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction. Despite modern antimicrobials and supportive therapy bacterial and fungal infections are still major complications in people with prolonged disease-related or treatment-related neutropenia. Transfusions of granulocytes have a long history of usage in clinical practice to support and treat severe infection in high-risk groups of patients with neutropenia or neutrophil dysfunction. However (...) , there is considerable current variability in therapeutic granulocyte transfusion practice, and uncertainty about the beneficial effect of transfusions given as an adjunct to antibiotics on mortality. This is an update of a Cochrane review first published in 2005.To determine the effectiveness and safety of granulocyte transfusions compared to no granulocyte transfusions as adjuncts to antimicrobials for treating infections in people with neutropenia or disorders of neutrophil function aimed at reducing mortality

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2016 Cochrane

19. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update.

Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update. | National Guideline Clearinghouse success fail JUN 10 2017 2018 2019 14 Apr 2018 - 12 Jul 2018 COLLECTED BY Organization: Formed in 2009, the Archive Team (not to be confused with the archive.org Archive (...) NGC:011254 2017 Jun 20 NEATS Assessment Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update. Lehrnbecher T, Robinson P, Fisher B, Alexander S, Ammann RA, Beauchemin M, Carlesse F, Groll AH, Haeusler GM, Santolaya M, Steinbach WJ, Castagnola E, Davis BL, Dupuis LL, Gaur AH, Tissing WJE, Zaoutis T, Phillips R, Sung L. Guideline for the management of fever and neutropenia in children with cancer

2017 National Guideline Clearinghouse (partial archive)

20. Management of Patients With Fever and Neutropenia Through the Arc of Time: A Narrative Review. (PubMed)

Management of Patients With Fever and Neutropenia Through the Arc of Time: A Narrative Review. The association between fever and neutropenia and the risk for life-threatening infections in patients receiving cytotoxic chemotherapy has been known for 50 years. Indeed, infectious complications have been a leading cause of morbidity and mortality in patients with cancer. This review chronicles the progress in defining and developing approaches to the management of fever and neutropenia through (...) of hematopoietic cytokines (especially granulocyte colony-stimulating factor) in shortening the duration of neutropenia, as well as with the discovery of more targeted cancer treatments that do not result in cytotoxicity, although these are still the exception. Most guiding principles that were developed decades ago-about when to begin empirical treatment after a neutropenic patient becomes febrile, whether and how to modify the initial treatment regimen (especially in patients with protracted neutropenia

2019 Annals of Internal Medicine

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