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Biomedical subjects

J Klastersky

Publications and source records attributed to J Klastersky.

At least 217 records · Page 12Linked to original sources
PubMed1984

111Indium-oxine-labeled leukocytes in the diagnosis of localized infection in patients with neoplastic disease.

One hundred twenty-nine 111In-oxine-labeled leukocyte scintiscans have been performed in 117 patients with cancer in order to diagnose localized infectious disease. Of the 115 contributive scans, 40 were in patients with localizing signs, whereas in 75 fever of unknown origin constituted the indication for this examination. The overall specificity of the method was 95.4%, the overall sensitivity 86%, and the global accuracy 91.3%. In 10 cases with localizing signs, the 111In-oxine granulocyte scintigram allowed exclusion of the diagnosis of infection, whereas in 17 instances without localizing signs, a focal infectious process was demonstrated. Heterologous donor leukocytes were used successfully in five instances. With the exception of accumulation of label at the site of an osteolytic metastasis in one case, no uptake was observed in primary or secondary tumors. It is concluded that 111In-oxine-labeled leukocytes constitute a valuable tool in the diagnosis and localization of infection in patients with malignant disease.

Bacterial Infections↗
PubMed1984

Phase II study of carminomycin in a human tumor cloning assay.

The anticancer activity of carminomycin was investigated in a human tumor cloning assay. No efficacy could be identified in the WiDr and the MCF7 cell lines which were highly responsive to doxorubicin. In addition, drug testing experiments were carried out in samples of various malignancies freshly obtained from 86 patients of whom 54 had not received prior anthracyclines. A reduction in the number of tumor colony forming units by 50% or more was seen in 1/26 breast cancers, 1/22 ovarian cancers and 1/7 melanomas. Cross-resistance studies indicated that eight tumors were responsive to doxorubicin only and one to carminomycin only whereas two were sensitive to both and 73 were resistant to both. This in vitro Phase II study corroborates the disappointing clinical results achieved with carminomycin.

Breast Neoplasms↗
PubMed1984

Significance of serum bactericidal activity in gram-negative bacillary bacteremia in patients with and without granulocytopenia.

Serum bactericidal activity was determined routinely in 89 patients with gram-negative bacillary bacteremia, 79 of whom were analyzed because they had granulocyte counts either below 100/mm3 or above 1,000/mm3. A peak (one hour after the administration of the antibiotics) serum bactericidal titer of 1:8 or more in non-granulocytopenic patients or 1:16 or more in severely granulocytopenic patients could be correlated with a favorable clinical response, in 98 percent (44 of 45) (p less than 0.0001) and 87 percent (20 of 23), (p less than 0.001) respectively. Granulocytopenic patients required a statistically significantly higher serum bactericidal activity for a favorable response. Serum bactericidal activity appears to be a useful and simple method to monitor antibiotic treatment in gram-negative bacillary bacteremia, especially when combination therapy is used.

Agranulocytosis↗
PubMed1984

Causes of death in febrile granulocytopenic cancer patients receiving empiric antibiotic therapy.

We reviewed the causes of death of 55 granulocytopenic patients who received empiric antibiotic treatment for fever according to an EORTC cooperative protocol; 53 presented cancer and 2 aplastic anemia. Among the 55 patients, 19 (35%) deaths were attributed to infection: 16 to bacterial and 3 to fungal infections. Among the patients with bacterial infections, 12 died from septic shock, 3 from pneumonia and 1 from Pseudomonas aeruginosa meningitis. The most frequent non-infectious causes of death were the cancer progression (18%) and hemorrhagic complications (27%), most often cerebromeningeal in relationship to thrombocytopenia. A large number of the patients who died from infection (78%) and hemorrhage (74%) had advanced cancer with poor chances to respond to anticancer therapy.

Adult↗
PubMed1984

Progress in chemotherapy of non-small cell lung cancer.

We reviewed the results in the literature on chemotherapy with cisplatin and/or other new agents such as etoposide and vindesine in the treatment of non-small cell lung cancer. Associations of cisplatin with vindesine or etoposide have been overall superior to combinations of older cytostatic agents. These combinations result in an average of 30-40% objective response rate with 5% complete responses. High doses of cisplatin seem to be associated with optimal results. Vinblastine, vincristine, bleomycin, methyl-GAG and dihydrogalactitol appear to be promising in combination with cisplatin.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

The combination of oxacillin with rifampicin in staphylococcal infections: a review of laboratory and clinical studies of the Institut Jules Bordet.

In-vitro study of the combination of oxacillin with rifampicin has shown that a complex interaction occurs between the two drugs: a high oxacillin/rifampicin ratio was associated with antagonism, a low ratio was more likely to result in synergy--the combination acquired a higher rate of killing. Oxacillin significantly prevented or delayed the regrowth of rifampicin-resistant mutants, and antagonism for high oxacillin/rifampicin ratios only affected rifampicin-susceptible strains. The two clinical studies that we have performed suggested that the addition of rifampicin to standard treatment improved the clinical outcome of the patients with staphylococcal infections, and this was particularly true for the most severe infections. Failures were not associated with the emergence of rifampicin-resistant strains; the combination was not associated with more superinfections nor with more toxicity or intolerance. Serum bactericidal activities reflected a similar complex interaction to that observed in vitro by time-kill curves or checkerboard techniques.

Adolescent↗
PubMed1984

Inactivation of netilmicin and amikacin by intact or disrupted leucocytes.

The bio-inactivation of netilmicin and amikacin by binding with intact and disrupted human normal leucocytes was compared. Even after prolonged incubation of the aminoglycosides with intact cells, no binding could be demonstrated. On the other hand, partial binding of netilmicin and amikacin by disrupted leucocytes occurred: a linear relationship between the logarithm of the initial number of cells and the degree of binding of the drug was observed. The decrease in biological activity occurred rapidly in the presence of disrupted cells and remained unchanged during the next 18 h.

Amikacin↗
PubMed1984

Serum bactericidal activity of aztreonam, cefoperazone, and amikacin, alone or in combination, against Escherichia coli, Klebsiella pneumoniae, Serratia marcescens, and Pseudomonas aeruginosa.

Serum samples from volunteers receiving (per kilogram) 20 mg of aztreonam, 20 mg of cefoperazone, 7.5 mg of amikacin, 20 mg of cefoperazone plus 20 mg of aztreonam, or 20 mg of aztreonam plus 7.5 mg of amikacin were evaluated for bactericidal activity against Escherichia coli, Klebsiella pneumonia, Serratia marcescens, and Pseudomonas aeruginosa. Serum bactericidal activities were similar for aztreonam alone or in combination but were lower for amikacin and cefoperazone alone, especially against S. marcescens and P. aeruginosa. Killing studies, performed with serum samples diluted 1:8, demonstrated a high killing rate for aztreonam plus amikacin, especially against P. aeruginosa.

Amikacin↗
PubMed1984

Single-drug versus combination empirical therapy for gram-negative bacillary infections in febrile cancer patients with and without granulocytopenia.

Empirical therapy with cefoperazone was compared with cefoperazone plus amikacin in granulocytopenic and nongranulocytopenic febrile patients. In nonneutropenic patients the overall response rate to cefoperazone was 88%; 10 of 12 gram-negative bacteremic patients were cured. Cefoperazone plus amikacin resulted in an 88% overall response rate and cured 14 of 15 patients with bacteremia. In neutropenic patients the overall response rate was 77% with cefoperazone alone and 73% with cefoperazone plus amikacin; the cure rates for gram-negative bacteremias were 8 of 11 and 6 of 12 patients, respectively. Our findings support the concept of single-drug empirical therapy with cefoperazone in febrile cancer patients, whether granulocytopenic or not, especially when gram-negative bacteremias are predominantly caused by Escherichia coli or Klebsiella species. The issue of Pseudomonas spp. and other more resistant pathogens needs further assessment with a larger number of patients.

Adolescent↗
PubMed1984

New antibacterial agents: the role of new penicillins and cephalosporins in the management of infection in granulocytopenic patients.

The result of the introduction of the new acyl-penicillins and the new cephalosporins has not, so far, been a major breakthrough in the empirical therapy of febrile episodes and infections in granulocytopenic patients. It remains to be seen whether other cephalosporins such as cefoperazone and ceftazidime will perform better in the future. Ceftazidime alone or in combination with aminoglycosides shows very promising early results. My present recommendation for empirical therapy in febrile neutropenic patients is to use a combination of a penicillin or a cephalosporin active against P. aeruginosa with an aminoglycoside. Special attention should be paid to the emergence of penicillin- and/or cephalosporin-resistant strains. Empirical therapy should be with antibiotics to which resistance is as rare as possible. In this respect, the newer compounds may play a role in the future. It should also be emphasized that clinical information about new drugs is at present based on the study of relatively small groups of patients. Larger studies performed in more homogeneous groups are needed better to define the role of new agents.

Agranulocytosis↗