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Clinics in haematology最新文献

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Interactions of oncogenes with haematopoietic cells. 癌基因与造血细胞的相互作用。
Pub Date : 1986-08-01
J H Pierce, A Eva, S A Aaronson
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引用次数: 0
12 Preleukaemia 12 白血病前期
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30013-4
H. Phillip Koeffler
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引用次数: 0
11 Lineage Heterogeneity in Acute Leukaemia: Acute Mixed-lineage Leukaemia and Lineage Switch 急性白血病的谱系异质性:急性混合谱系白血病和谱系转换
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30012-2
Sanford A. Stass, Joseph Mirro Jr
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引用次数: 0
2 Interactions of Oncogenes with Haematopoietic Cells 2癌基因与造血细胞的相互作用
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30003-1
Jacalyn H. Pierce, Alessandra Eva, Stuart A. Aaronson
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引用次数: 0
4 Differentiation-linked Gene Rearrangement and Expression in Acute Lymphoblastic Leukaemia 急性淋巴细胞白血病中分化相关基因重排和表达
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30005-5
M.F. Greaves, S. Mizutani, A.J.W. Furley, D.R. Sutherland, L.C. Chan, A.M. Ford, Η.V. Molgaard
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引用次数: 0
Infection and transfusion therapy in acute leukaemia. 急性白血病的感染与输血治疗。
Pub Date : 1986-08-01
W G Ho, D J Winston

Granulocytopenia is the single most important risk factor for infection in patients with acute leukaemia. There are limitations to the effective prophylaxis of infection in granulocytopenic patients, but practical measures include the management of the patient in a private hospital room, the requirement of all medical personnel and visitors to wash their hands carefully and to wear masks, restricting the patient to a low-bacteria diet devoid of fresh fruit, vegetables and salads, and the administration of oral antimicrobial agents for gastrointestinal decontamination. When fever develops, empirical therapy with a combination of an aminoglycoside plus an antipseudomonal beta-lactam should be started promptly. A double beta-lactam combination of cefoperazone or ceftazidime plus piperacillin can be substituted if nephrotoxicity is a concern. The addition of empirical intravenous amphotericin may be useful in patients who remain febrile and granulocytopenic on broad-spectrum antibiotics, especially if surveillance cultures indicate fungal colonization. Amphotericin is also the most reliable agent for the treatment of established fungal infections. Acyclovir is not recommended for prophylaxis in acute leukaemia patients but should be reserved for the treatment of well-documented and clinically significant herpes simplex viral infections. During periods of remission, most patients with AML remain free of infection except when they become granulocytopenic again during intensification or consolidation chemotherapy. On the other hand, children with ALL in remission may experience frequent infections unrelated to granulocytopenia as a consequence of their maintenance chemotherapy. Pneumocystis carinii, varicella zoster, and other viruses are common pathogens. Trimethoprim-sulphamethoxazole is effective prophylaxis against Pneumocystis carinii pneumonia in patients with ALL, while intravenous acyclovir is the drug of choice for treatment of varicella zoster infection. Transfusion therapy in the acute leukaemia patient is guided by the patient's peripheral blood counts and degree of sensitization to blood products. Generally, packed red blood cells are given in order to maintain the haematocrit at greater than 30%, while random-donor platelets are administered to keep the platelet count at greater than 20 X 10(9)/l. If refractoriness to platelet transfusions develops, HLA-matched platelets from family members or selected unrelated donors can be used. Similarly, washed or filtered red blood cells may be given to patients with previous and recurrent non-haemolytic febrile reactions to red blood cell transfusions.(ABSTRACT TRUNCATED AT 400 WORDS)

粒细胞减少症是急性白血病患者感染的唯一最重要的危险因素。有效预防粒细胞减少患者感染存在局限性,但切实可行的措施包括在私人病房对患者进行管理,要求所有医务人员和访客仔细洗手并戴口罩,限制患者食用不含新鲜水果、蔬菜和沙拉的低细菌饮食,以及口服抗菌剂以净化胃肠道。当出现发热时,应立即开始氨基糖苷加抗假单胞菌β -内酰胺的经验性治疗。如果担心肾毒性,可采用头孢哌酮或头孢他啶加哌拉西林的双β -内酰胺组合。经验性静脉注射两性霉素可能对使用广谱抗生素仍有发热和粒细胞减少的患者有用,特别是如果监测培养表明真菌定植。两性霉素也是治疗真菌感染最可靠的药物。阿昔洛韦不推荐用于急性白血病患者的预防,但应保留用于治疗有充分证据和临床意义的单纯疱疹病毒感染。在缓解期,大多数AML患者保持无感染,除非在强化或巩固化疗期间再次出现粒细胞减少。另一方面,急性淋巴细胞白血病缓解期的儿童可能由于维持化疗而频繁出现与粒细胞减少症无关的感染。卡氏肺囊虫、水痘带状疱疹和其他病毒是常见的病原体。甲氧苄啶-磺胺甲恶唑是ALL患者预防卡氏肺囊虫肺炎的有效药物,而静脉注射阿昔洛韦是治疗水痘带状疱疹感染的首选药物。急性白血病患者的输血治疗以患者外周血计数和对血液制品的敏感程度为指导。一般情况下,给予填充红细胞是为了保持红细胞压积大于30%,而给予随机供体血小板是为了保持血小板计数大于20 × 10(9)/l。如果出现对血小板输注的难耐,可以使用来自家庭成员或选择的非亲属供体的hla匹配的血小板。同样地,对于以前和反复对红细胞输注有非溶血性发热反应的患者,可给予洗过或过滤过的红细胞。(摘要删节为400字)
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引用次数: 0
10 Acute Myeloid Leukaemia: Recent Advances in Therapy 急性髓性白血病:治疗的最新进展
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30011-0
Robert Peter Gale, Kenneth A. Foon
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引用次数: 0
5 Biology of Acute Myeloid Leukaemia 5急性髓性白血病的生物学
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30006-7
H.A. Messner, J.D. Griffin
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引用次数: 0
3 Prognostic Significance of Chromosomal Abnormalities in Acute Leukaemias and Myelodysplastic Syndromes 3急性白血病和骨髓增生异常综合征中染色体异常的预后意义
Pub Date : 1986-08-01 DOI: 10.1016/S0308-2261(18)30004-3
Jorge J. Yunis, Richard D. Brunning
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引用次数: 0
Acute leukaemias: biology and treatment. 急性白血病:生物学和治疗。
Pub Date : 1986-08-01
R P Gale, A V Hoffbrand
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引用次数: 0
期刊
Clinics in haematology
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