Showing papers by "Christian Junghanss published in 2006"
TL;DR: There were no differences in the efficacy and safety of itraconazole and fluconazole prophylaxis in neutropenic patients with haematological malignancies and no differences were detected between treatment groups in proven or suspected invasive fungal infections or other endpoints.
Abstract: OBJECTIVES: This trial studied the efficacy and safety of itraconazole and fluconazole in the prevention of invasive fungal infections in neutropenic patients with haematological malignancies. PATIENTS AND METHODS: An 8 week, open-label, randomized, parallel-group, multicentre trial comparing itraconazole oral solution (2.5 mg/kg twice daily; N=248) with fluconazole oral solution or capsules (400 mg daily; N=246) in 494 patients with anticipated profound neutropenia (i.e. neutrophil count expected to be <500 cells/mm3 for at least 10 days) from tertiary care centres. RESULTS: Invasive fungal infections were reported for 4 out of 248 patients (1.6%) in the itraconazole group and 5 out of 246 patients (2.0%) in the fluconazole group. Invasive Aspergillus infections were proven for 2 out of 248 patients (0.8%) in the itraconazole group and 3 out of 246 patients (1.2%) in the fluconazole group. For both the ITT and profoundly neutropenic populations, no differences were detected between treatment groups in proven or suspected invasive fungal infections or other endpoints. The mortality rates owing to proven invasive fungal infections were 2 out of 248 patients (0.8%) for the itraconazole group and 3 out of 246 patients (1.2%) for the fluconazole group. There was also no difference between treatment groups in the number of patients who recovered from neutropenia or in the duration of neutropenia. More discontinuation of drug intake owing to nausea and more hypokalaemia occurred in the itraconazole group, other adverse events and the total number of adverse events were similar in both groups. CONCLUSIONS: In this study there were no differences in the efficacy and safety of itraconazole and fluconazole prophylaxis in neutropenic patients with haematological malignancies.
102 citations
TL;DR: It is demonstrated that replacement of calcineurin inhibitors by daclizumab can improve TAM and RI, however, mortality remains high in patients with acute GVHD.
Abstract: Transplantation-associated microangiopathy (TAM) or renal insufficiency (RI) after allogeneic hematopoietic stem cell transplantation is associated with a high mortality. As calcineurin inhibitors (CI) may contribute to TAM or RI, we evaluated the efficacy of replacing CI by daclizumab in patients with graft-versus-host disease (GVHD). Thirteen patients with GVHD-associated TAM and five patients with RI were treated with daclizumab 1 mg/kg intravenous (i.v.)/week, discontinuation of the CI and continuation of the remaining GVHD treatment. All patients had acute GVHD (steroid-sensitive (n=4), steroid-refractory (n=10)) or chronic GVHD (n=4) and were treated with CI before the start of daclizumab. Nine of 13 patients with TAM treated with daclizumab and discontinuation of CI achieved complete remission of TAM, two had stable disease, and one patient did not respond. Patients receiving daclizumab for RI without TAM showed stabilization (2/5) or improvement (3/5) of renal function. Four of 14 patients with acute GVHD achieved CR, two partial remission, eight patients did not respond and 11/14 died at a median of 39 days after start of the daclizumab. Our data demonstrate that replacement of CI by daclizumab can improve TAM and RI. However, mortality remains high in patients with acute GVHD.
50 citations
TL;DR: A 36-year-old man with Ann Arbor stage IIIBE peripheral T-cell lymphoma was treated with combined intra-thecal and systemic chemotherapy including intravenous (i.v.) MTX by applying the GMALL-B-ALL/NHL 2002 protocol and died from severe sepsis after HSCT.
Abstract: Chronic bilateral subdural hematoma (SDH) is a rare but serious complication after hematopoietic stem cell transplantation (HSCT) [1-3]. Risk factors such as thrombocytopenia, intra-thecal chemothe...
4 citations
TL;DR: Delayed and poor engraftment is a well-known complication after T-cell-depleted allogeneic BMT and may favour a transient immune system imbalance with delayed reconstitution of T- cell immunity.
Abstract: Delayed and poor engraftment is a well-known complication after T-cell-depleted allogeneic BMT and may favour a transient immune system imbalance with delayed reconstitution of T-cell immunity.1, 2
3 citations