Incidence Rates Of Leukopenia Research Articles

Safety of linezolid, rifampicin, and clindamycin combination therapy in patients with prosthetic joint infection.

We investigated adverse events in patients with prosthetic joint infections receiving combination therapy with linezolid, rifampicin, and clindamycin for ≥ 7 days. Twenty-two patients were evaluated. The combination therapy was administered for 15.5 (7-29) days at dosages of 1200, 450, and 450-1200 mg/day for linezolid, rifampicin, and clindamycin, respectively. Adverse events (gastrointestinal, eye, and skin disorders; liver damage; myelosuppression; hyponatremia, and others) were recorded. The incidence rates of leukopenia, neutropenia, anemia, thrombocytopenia, and hyponatremia were 36.4%, 31.8%, 40.9%, 18.2%, and 18.2%, respectively. Common Terminology Criteria for Adverse Events version 5.0 Grade 3 neutropenia, anemia, and hyponatremia were observed. The incidence rate of myelosuppression was higher following combination therapy compared with that previously reported following single-drug administration. All patients were discharged after the infection was under control. It is important to monitor these adverse events during combination therapy with the aforementioned agents; these conditions may be relieved by discontinuing linezolid.

Combination of icotinib and chemotherapy as first-line treatment for advanced lung adenocarcinoma in patients with sensitive EGFR mutations: A randomized controlled study

ObjectiveTo explore the efficacy and safety of icotinib with chemotherapy as first-line therapy for advanced lung adenocarcinoma in patients with sensitive epidermal growth factor receptor (EGFR) mutations. MethodsThis prospective, randomized, controlled trial was conducted in 10 general hospitals in Shandong Province, China. Previously untreated patients with advanced lung adenocarcinoma and sensitive EGFR mutations were recruited between January 16, 2014 and December 31, 2016 and randomly allocated to the combination group (icotinib plus pemetrexed and carboplatin) or the icotinib only group. The patients were followed up until May 23, 2018. The primary endpoint was progression-free survival (PFS). ResultsThe efficacy analysis (intention-to-treat analysis) include 179 patients (n = 90 in the combination group and n = 89 in the icotinib only group). PFS was significantly longer in the combination group than in the icotinib only group (16.0 months vs. 10.0 months, hazard ratio [HR] = 0.59, 95% confidence interval [CI] 0.42–0.84, P = 0.003). The objective response rate and the disease control rate for the combination group were significantly higher than those for the icotinib only group (77.8% vs. 64.0%, χ2 = 4.094, P = 0.043; 91.1% vs. 79.8%, χ2 = 4.632, P = 0.031). However, overall survival did not differ between the two groups (36.0 months vs. 34.0 months, HR = 0.81, 95%CI 0.54–1.22, P = 0.309). The incidence rates of leukopenia and liver function damage of grades 3–4 were higher in the combination group than in the icotinib only group (12.2% vs. 0%, χ2 = 11.086, P = 0.001; 12.2% vs. 3.5%, χ2 = 4.488, P = 0.034). However, adverse events were resolved in most patients. ConclusionUse of the combination of icotinib and chemotherapy as first-line therapy significantly improved the PFS of advanced lung adenocarcinoma patients with sensitive EGFR mutations. Although the combination therapy increased the incidence of leukopenia and liver function damage, the observed adverse events were tolerable and manageable.

Increase in white cell and neutrophil counts during the first eighteen weeks of treatment with clozapine in patients admitted to a long-term psychiatric care inpatient unit

IntroductionClozapine is an antipsychotic drug that has shown to be more effective than other antipsychotics in the treatment of schizophrenia, but its use is limited due to its side effects, particularly by the risk of causing agranulocytosis. A study was made on the variations in white cell and neutrophil counts in patients treated with Clozapine in a Long-term Psychiatric Unit. MethodsA retrospective observational study was conducted with a sample of women of our long-term psychiatric care unit who had been treated with Clozapine. A study was made on the variations in white cell and neutrophil counts during the first 18 weeks of treatment, as well as the onset of leukopenia, neutropenia, agranulocytosis, and the influence of concomitant drugs. Results and conclusionsThe study included 55 patients on treatment with Clozapine. The incidence rate of neutropenia was 1.82% (95% CI: 0.05–10.13). The incidence rate of leukopenia and agranulocytosis was 0%. An increase in white cell and neutrophil counts from baseline to week 3–4 was observed. Only small variations were observed after this time, but the counts remained higher than the initial values. These changes were statistically significant in the white cell count: One-way repeated ANOVA with Greenhouse–Geisser correction F (11.47, 37)=2.114 (P=.011); and in neutrophils: One-way repeated ANOVA with Greenhouse–Geisser correction F (10.3, 37)=3.312 (P=.0002), and MANOVA F (18, 37)=2.693 (P=.005), ηP2=0.567. The influence of concomitant drugs (lithium, valproic and biperiden) was not significant on the overall increase found in white cells or neutrophils (MANOVA).

Clinical study of S-1 alone compared to gemcitabine combined with S-1 in treatment of patients with advanced pancreatic cancer

Objective To value the clinical efficacy and toxicity of S-1 compared to gemcitabine combined with S-1 in treatment of patients with advanced pancreatic cancer. Methods From January 2011 to December 2013, the data of 46 patients with advanced pancreatic cancer were analyzed retrospectively, including 24 patients receiving S-1 alone (group A) and 22 patients who received gemcitabine combined with S-1 (group B). The results were evaluated by objective response rate (ORR), disease control rate (DCR), survival time and safety. Results In group A the ORR was 20.8 % (5/24), DCR was 66.7 % (16/24), median progression-free survival was 4.8 months, median overall survival was 9.6 months, and 1 year survival was 12.5 %. In group B the ORR was 27.3 % (6/22), DCR was 72.7 % (16/22), median progression-free survival was 5.9 months, median overall survival was 10.3 months, and 1 year survival was 22.7 %. There was no significant difference between the two groups (P>0.05). The incidence rates of leukopenia, neutropenia and thrombopenia in group A were significantly lower than those in group B (P<0.05). Conclusion S-1 alone and gemcitabine combined with S-1 have similar effects in the treatment of advanced pancreatic cancer, but the toxicity of S-1 is mild and tolerable. Key words: Pancreatic neoplasms; S-1; Gemcitabine

Epidemiological study of cytopenia among benzene-exposed workers and its influential factors

To evaluate the benzene exposure level and cytopenia among the benzene exposed workers in Shanghai, China and to analyze the influential factors for the health of benzene-exposed workers. A total of 3314 benzene-exposed workers, who were from 85 benzene-related enterprises selected by stratified random sampling based on enterprise sizes and industries, were included in the study. The time-weighted average (TWA) concentration of benzene in each workshop was measured by individual sampling and fixed point sampling, and the benzene exposure level in workshop was evaluated accordingly. The occupational health examination results and health status of benzene-exposed workers were collected. The median of TW A concentrations of benzene was 0.3 mg/m3. The TWA concentrations measured at 7 ( 1.4%) of the 504 sampling points were above the safety limit. Of the 7 points, 3 were from large enterprises, 2 from medium enterprises, and 2 from small enterprises; 3 were from shipbuilding industry, 1 from chemical industry, and 3 from light industry. Of the 3314 benzene-exposed workers, 451 ( 13.6%) had cytopenia, including 339 males ( 339/2548, 13.3%) and 112 females ( 112/766, 14.6% ). There were significant differences in the incidence rates of leukopenia and neutropenia among the benzene-exposed workers of different sexes and ages (P<0.05); there were significant differences in the incidence rate of cytopenia among the benzene-exposed workers of different ages and working years ( P<0.05 ); there were significant differences in the incidence of neutropenia among the benzene exposed workers of different working years ( P<0.05). Monitoring and intervention measures should be enhanced to protect the benzene-exposed workers in the large enterprises in shipbuilding industry and medium and private enterprises in chemical industry from occupational hazards.

Gemcitabine combined with nedaplatin for elderly patients with advanced non-small cell lung cancer

Objective To explore the efficacy and toxic reaction of gemcitabine ( GEM ) combined with nedaplatin ( NDP )in the treatment of elder patients with advanced non-small cell lung cancer ( NSCLC ).Methods 70 patients with advanced NSCLC comfirmed by pathology or cytology who had been treated from June 2009 to June 2011 were included in this study.The patients were randomly assigned to receive GEM plus either NDP ( 35 patients,study group ),or DDP ( 35 patients,control group ).The efficacy was assessed after two cycles of treatment.Results The total effectiveness rate,median survival duration,and one-year survival rate did not differ significantly between the study group and the control group( 40.0％ vs.42.8％,8.7 months vs.9.2 months,and 33.5％ vs.32.7％ P＞ 0.05 ).The incidence rates of leukopenia,decreased haemoglobin level,and thrombocytopenia were 54.3％,34.2％,and 57％in the control group and 57％,42.8％,and 62.9％ in the study group,respectively.There was no statistical significance ( P ＞ 0.05 ).The incidence rate of gastrointestinal reactions was significantly lower in the study group than in the control group( P＜ 0.05 ).The rate of liver and kidney function damage was lower,with no significant difference between the two groups ( P＞ 0.05 ).Conclusions Platin-based chemotherapy is efficacious in the treatment of advanced NSCLC.GEM combined NDP has a similar efficacy with GEM plus DDP.NDP has lower gastrointestinal reaction,lower hepatorenal toxicity,and higher tolerance and compliance in patients. Key words: Gemcitabine; Nedaplatin; Cisplatin; Non-small cell lung cancer; Chemotherapy

Leukopenia due to anti-tuberculous chemotherapy including rifampicin and isoniazid

Leukopenia due to anti-tuberculous chemotherapy including rifampicin and isoniazid