BACKGROUND Cytomegalovirus(CMV)prophylaxis with valganciclovir and ganciclovir is associated with elevated neutropenia and leukopenia risk in kidney transplant recipients,although the impact of these events on healthc...BACKGROUND Cytomegalovirus(CMV)prophylaxis with valganciclovir and ganciclovir is associated with elevated neutropenia and leukopenia risk in kidney transplant recipients,although the impact of these events on healthcare resource utilization(HCRU)and clinical outcomes is unclear.AIM To quantify clinical events and HCRU associated with neutropenia and leukope-nia among adults receiving valganciclovir and/or ganciclovir post-kidney trans-plantation.METHODS Adult kidney transplant recipients receiving valganciclovir and/or ganciclovir prophylaxis were identified in the TriNetX database from 2012 to 2021.Patient characteristics were evaluated in the 1-year period pre-first transplant.HCRU and adjusted event rates per person-year were evaluated in follow-up year 1 and years 2-5 after first kidney transplantation among cohorts with vs without neutropenia and/or leukopenia.RESULTS Of 15398 identified patients,the average age was 52.39 years and 58.70%were male.Patients with neutropenia and/or leukopenia had greater risk of clinical events for CMV-related events,opportunistic infections,use of granulocyte colony stimulating factor,and hospitalizations(relative risk>1 in year 1 and years 2-5).Patients with vs without neutropenia and/or leukopenia had higher HCRU in year 1 and years 2-5 post kidney transplantation,including the mean number of inpatient admissions(year 1:3.47 vs 2.76;years 2-5:2.70 vs 2.29)and outpatient visits(48.97 vs 34.42;31.73 vs 15.59,respectively),as well as the mean number of labs(1654.55 vs 1182.27;622.37 vs 327.89).CONCLUSION Adults receiving valganciclovir and/or ganciclovir prophylaxis post-kidney transplantation had greater risk of neutropenia and/or leukopenia,which were associated with higher clinical event rates and HCRU up to 5 years post-transplantation.These findings suggest the need for alternative prophylaxis options with lower myelosup-pressive effects to improve patient outcomes.展开更多
OBJECTIVE:To systematically assess the safety and effectiveness of Compound E’jiao Jiang(复方阿胶浆,CEJ)for treating leukopenia.METHODS:Four English and four Chinese databases were searched for randomized controlled ...OBJECTIVE:To systematically assess the safety and effectiveness of Compound E’jiao Jiang(复方阿胶浆,CEJ)for treating leukopenia.METHODS:Four English and four Chinese databases were searched for randomized controlled trials(RCTs)on CEJ for treating leukopenia up to July 1,2024.Two researchers independently screened the studies and extracted necessary data.Methodological quality and risk of bias were assessed using the Cochrane risk-of-bias tool.Articles eligible for Meta-analysis were analyzed using RevMan.RESULTS:A total of 28 RCTs involving 2041 participants were included,with 1034 in the experimental group and 1007 in the control group.The Meta-analysis showed a significant effect of CEJ in treating leukopenia caused by tumor and immune diseases(three RCTs)[risk ratio(RR)=1.17,95%confidence interval(CI)(1.08,1.27),P=0.0002,I^(2)=35%].The combination of CEJ and Western Medicine showed superior results in terms of white blood cell(WBC)counts(fifteen RCTs)[mean difference(MD)=1.12,95%CI(0.83,1.42),P<0.00001,I^(2)=88%],Karnofsky Performance Status(KPS)levels(seven RCTs)[RR=1.39,95%CI(1.25,1.55),P<0.00001,I^(2)=36%],and mitigation of bone marrow toxicity(eleven RCTs)[RR=0.61,95%CI(0.54,0.69),P<0.00001,I^(2)=24%]compared to Western Medicine alone.Adverse events mainly included gastrointestinal and digestive reactions associated with chemotherapy drugs.CONCLUSION:CEJ alone or in combination with Western Medicine for treating leukopenia caused by tumor and immune diseases improved WBC counts,clinical efficacy,and quality of life.It also reduced bone marrow toxicity-induced leukopenia,enhanced the efficacy of chemotherapy while reducing its toxicity,and alleviated symptoms.No significant adverse events were reported in the RCTs,indicating favorable efficacy and safety.The Grading of Recommendations Assessment,Development and Evaluation assessment indicated a low level of evidence for CEJ in improving leukocyte elevation efficacy,KPS levels,and myelosuppressive toxicity.Therefore,large-scale,high-quality,rigorous multicenter double-blind controlled trials are recommended to strengthen the evidence level.展开更多
BACKGROUND Thiopurine-induced leukopenia(TIL)is a life-threatening toxicity and occurs with a high frequency in the Asian population.Although nucleoside diphosphate-linked moiety X-type motif 15(NUDT15)variants signif...BACKGROUND Thiopurine-induced leukopenia(TIL)is a life-threatening toxicity and occurs with a high frequency in the Asian population.Although nucleoside diphosphate-linked moiety X-type motif 15(NUDT15)variants significantly improve the predictive sensitivity of TIL,more than 50%of cases of this toxicity cannot be predicted by this mutation.The potential use of the 6-thioguanine nucleotide(6TGN)level to predict TIL has been explored,but no decisive conclusion has been reached.Can we increase the predictive sensitivity based on 6TGN by subgrouping patients according to their NUDT15 R139C genotypes?AIM To determine the 6TGN cut-off levels after dividing patients into subgroups according to their NUDT15 R139C genotypes.METHODS Patients’clinical and epidemiological characteristics were collected from medical records from July 2014 to February 2017.NUDT15 R139C,thiopurine S methyltransferase,and 6TGN concentrations were measured.RESULTS A total of 411 Crohn’s disease patients were included.TIL was observed in 72 individuals with a median 6TGN level of 323.4 pmol/8×10^8 red blood cells(RBC),which was not different from that of patients without TIL(P=0.071).Then,we compared the 6TGN levels based on NUDT15 R139C.For CC(n=342)and CT(n=65)genotypes,the median 6TGN level in patients with TIL was significantly higher than that in patients without(474.8 vs 306.0 pmol/8×10^8 RBC,P=9.4×10-^5;291.7 vs 217.6 pmol/8×10^8 RBC,P=0.039,respectively).The four TT carriers developed TIL,with a median 6TGN concentration of 135.8 pmol/8×10^8 RBC.The 6TGN cut-off levels were 411.5 and 319.2 pmol/8×108 RBC for the CC and CT groups,respectively.CONCLUSION The predictive sensitivity of TIL based on 6TGN is dramatically increased after subgrouping according to NUDT15 R139C genotypes.Applying 6TGN cut-off levels to adjust thiopurine therapies based on NUDT15 is strongly recommended.展开更多
Objective: Chemotherapy is the standard treatment for small-cell lung cancer (SCLC), and leukopenia is a common side effect. This study assesses whether chemotherapy-induced leukopenia is a predictor of efficacy and w...Objective: Chemotherapy is the standard treatment for small-cell lung cancer (SCLC), and leukopenia is a common side effect. This study assesses whether chemotherapy-induced leukopenia is a predictor of efficacy and whether it is associated with the survival of SCLC patients. Methods: A retrospective analysis was conducted on data from 445 patients with SCLC who received standard chemotherapy for 4 to 10 cycles. The World Health Organization grading system classifies leukopenia during chemotherapy as follows: absent (grade 0), mild (grades 1 and 2), or severe (grades 3 and 4). The primary endpoint is overall survival (OS). Results: The association between chemotherapy-induced leukopenia and OS was assessed. According to a multivariate Cox model with time-varying covariates, the hazard ratio of death was significantly lower among patients with mild leukopenia than among patients with severe leukopenia at 0.687 (0.506 to 0.943) and 1.414 (1.147 to 1.744), respectively. The median survival was 13 months (95% CI: 11 to 15 months) for patients who did not experience leukopenia, 17 months (95% CI: 14 to 18 months) for those with mild leukopenia, and 14 months (95% CI: 13 to 16 months) for those with severe leukopenia (absent vs. mild vs. severe leukopenia, P=0.047). Conclusion: Leukopenia during chemotherapy is associated with the survival of SCLC patients. Mild leukopenia is strongly associated with longer survival time.展开更多
Objective： To evaluate the efficacy and safety of sodium copper chlorophyllin （trademarked as ＂Yebaike Tablet （叶拜克） which is abbreviated as YBK in treating leukopenia. Methods： One hundred and five patients w...Objective： To evaluate the efficacy and safety of sodium copper chlorophyllin （trademarked as ＂Yebaike Tablet （叶拜克） which is abbreviated as YBK in treating leukopenia. Methods： One hundred and five patients with leukopenia caused by various factors were randomized into 3 groups. The 60 patients in the YBK group took orally YBK Tablets at the dose of 40 mg, three times per day, the 30 patients in the leucogen group were treated with Leucogen Tablets （利血生片） at the dose of 20 mg, three times per day, and the 15 patients in the placebo group were administered with vitamin C tablets 100 mg, three times per day. All the subjects were treated for 1 month. The change of peripheral leucocytes count after treatment and adverse drug reaction that occurred in patients were studied. Results： In the 60 patients treated with YBK, the treatment proved to be markedly effective in 34 cases, effective in 17 and ineffective in 9, the total effective rate being 85%, which was significantly higher than that in the placebo group （26.7%, P〈0.01） and similar to that in the leucogen group （83.3 %, P〉0.05）. No adverse reaction was found in the treatment course. Conclusion： YBK can be used in the treatment of leukopenia caused by various factors, satisfactory in efficacy and safe in use.展开更多
AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy(HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared.METHODS: Two pat...AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy(HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared.METHODS: Two patient cohorts were retrospectively analyzed regarding the incidence of postoperative leukopenia. The first cohort(n = 32) received Mitomycin C(MMC)-based HIPEC intraperitoneally(35 mg/m2 for 90 min) and the second cohort(n = 10) received a bidirectional therapy consisting of oxaliplatin(OX)(300 mg/m2 for 30 min) intraperitoneally and 5-fluorouracil(5-FU) 400 mg/m2 plus folinic acid 20 mg/m2 intravenously. The following data were collected retrospectively: Age, sex, length of operation, length of hospital stay, amount of resection including extent of peritonectomy, peritoneal cancer index, CC(completeness of cytoreduction)-status and leukocyte-count before cytoreductive surgery(CRS) and HIPEC, on days 3, 7 and 14 after CRS and HIPEC. HIPEC leukopenia was defined as < 4000 cells/m3. RESULTS: Leukopenia occurred statistically more often in the MMC than in the OX/5-FU-group(10/32 vs 0/10; P = 0.042). Leukopenia set-on was on day 7 after CRS and MMC-HIPEC and lasted for two to three days. Three patients(33%) required medical treatment. Patients affected by leukopenia were predominantly female(7/10 patients) and older than 50 years(8/10 patients). Thelength of hospital stay tended to be higher in the MMCgroup without reaching statistical significance(22.5± 11 vs 16.5 ± 3.5 d). Length of operation(08:54 ± 01:44 vs 09:48 ± 02:28 h) were comparable between patients with and without postoperative leukopenia. Prior history of systemic chemotherapy did not trigger postHIPEC leukopenia. Occurrence of leucopenia did not trigger surgical site infections, intraabdominal abscess formations, hospital-acquired pneumonia or anastomotic insufficiencies. CONCLUSION: Surgeons must be aware that there is a higher incidence of postoperative leukopenia in MMCbased HIPEC protocols primarily affecting females and older patients.展开更多
In recent years, leukopenia is clinically very common. The leukopenic patient is significantly low in immunocompetence and is likely to suffer from various kinds of infections. Zusanli (St 36), an
From April 1992 to April 1998, 104 cases of chemotherapy-induced leukopenia were treated by injection into Zusanli (ST 36) with a mixture consisting of dexamethasone, 654-2, ATP and inosine. The therapeutic results we...From April 1992 to April 1998, 104 cases of chemotherapy-induced leukopenia were treated by injection into Zusanli (ST 36) with a mixture consisting of dexamethasone, 654-2, ATP and inosine. The therapeutic results were satisfactory as reported in the following.Clinical Data In this series, all the 127 cases were definitely diagnosed by pathological examination. Of them, 93 were male and 34 female, ranging in age from 12 to 75 years. 38 cases were carcinoma of esophagus, 22 carcinoma of cardia of stomach, 21 cancer of lung, 11 hepatic carcinoma, 8 lymphoma, 8 mammary cancer, 7 carcinoma of colon, and 12 other kinds of the tumors. Leukocyte count was below 4.0×109/L in all the patients after being treated by chemotherapy.展开更多
BACKGROUND Thrombocytopenia is a common complication of invasive liver abscess syndrome(ILAS)by Klebsiella pneumoniae(K.pneumoniae)infection,which indicates severe infection and a poor prognosis.However,the presence o...BACKGROUND Thrombocytopenia is a common complication of invasive liver abscess syndrome(ILAS)by Klebsiella pneumoniae(K.pneumoniae)infection,which indicates severe infection and a poor prognosis.However,the presence of leukopenia is rare.There are rare reports on leukopenia and its clinical significance for ILAS,and there is currently no recognized treatment plan.Early and broad-spectrum antimi-crobial therapy may be an effective therapy for treating ILAS and improving its prognosis.CASE SUMMARY A 55-year-old male patient who developed fever,chills,and abdominal distension without an obvious cause presented to the hospital for treatment.Laboratory tests revealed thrombocytopenia,leukopenia,and multiple organ dysfunction.Imaging examinations revealed an abscess in the right lobe of the liver and thromboph-lebitis,and K.pneumoniae was detected in the blood cultures.Since the patient was diabetic and had multi-system involvement,he was diagnosed with ILAS accom-panied by leukopenia and thrombocytopenia.After antibiotic treatment and sys-temic supportive therapy,the symptoms disappeared,and the patient’s condition almost completely resolved.CONCLUSION Leukopenia is a rare complication of ILAS,which serves as an indicator of adverse prognostic outcomes and the severity of infection.展开更多
ACPRs of leukopenia in peripheral blood of workers exposed to benzene in small-scale industries are calculated using capture-recapture methods. The results from two figures with 6-month apart demonstrate that the ACPR...ACPRs of leukopenia in peripheral blood of workers exposed to benzene in small-scale industries are calculated using capture-recapture methods. The results from two figures with 6-month apart demonstrate that the ACPR in workers exposed to benzene is 36.81(29. 14-44.48)%, significantly higher than that of control 12.71(7.20-18.22)% (P<0.05),with a relative risk of 2.9. The prevalences of 4 cross-sectional investigations in exposure group calculated with routine method are 18.73%, 26.37%, 27.93%, and 36.76% respectively;in controls, 8.38%, 6.85%, 7.94%, and 15.00% respectively and all fall in the range of 95% CI of ACPR. It is suggested that the methods of calculating ACPR by capture-recapture methods is simple, feasible and efficient, with the results more precise than with traditional methods.展开更多
Objective: to treat leukemia patients with chemotherapy with leukemia reduction symptoms with left supplemented myeloid blood soup and analyze its effect. Methods: a total of 82 patients were selected by double-blind ...Objective: to treat leukemia patients with chemotherapy with leukemia reduction symptoms with left supplemented myeloid blood soup and analyze its effect. Methods: a total of 82 patients were selected by double-blind method, including conventional treatment (group A) and left supplementary pulp blood soup (group B), to compare the effects of different treatment methods. Results: comparison with Group A, Group B had a significant curative effect (P <0.05);Group B WBC (leukocyte count), Hb (hemoglobin), GRA (neutrophil count), and PLT (platelet count) were (4.65 ± 0.51) 109 / L, (132.52 ± 16.35) g / L, (3.78 ± 0.52) 109 / L, (195.46 ± 11.52) 109 / L were all higher than Group A (3.65 ± 0.55) 109 / L, (115.63 ± 16.52) g / L, (2.56 ± 0.5) 109 / L, (118.62 ± 11. 32)×109/L(P<0.05);In Group B, the soluble intercell adhesion molecule-1 (sICAM-1) and serum superoxide dismutase (SOD) were (265.35 ± 76.25) ng/mL, (331.65 ± 45.74) μg/L were higher than the (400.32 ± 99.32) ng/mL, and (281.25 ± 45.26) μg/L in Group A, Serotransformed growth factor-1 (TGF-1), lipid peroxide (LPO) were (32.65 ± 6.25) ng/mL, (1.51 ± 0.42) μmol/L were lower than (16.53 ± 5.23) ng/mL, and (1.85 ± 0.43) μmol/L (P <0.05);Group A dizziness, less food and fatigue were (1.06 ± 0.55), (1.23 ± 0.55), (1.33 ± 0.36) were all below (3.02 ± 0.56), (2.85 ± 0.52), (2.65 ± 0.41) (P <0.05);There was no difference in the adverse effects between the two groups (P> 0.05).To observe the clinical efficacy of left myeloid blood soup for leukopenia after leukemia chemotherapy;Methods: 42 patients with leukopenia after leukemia chemotherapy were randomly divided into treatment group and control group. 21 patients in each group were treated with oral squalshark hepatol and vitamin B4 tablets based on oral shark hepatol tablets and vitamin B4 tablets. The result was 80.95%, 42.85% (P0.05);Conclusion: It had obvious effect on leukopenia after leukemia chemotherapy. Conclusion: the treatment of left supplementary pulp blood soup can significantly improve the number of white blood cells in patients, promote the recovery of various symptoms, and significantly improve the patient's condition. There were 13 infections during treatment, average antibiotic time (7.01 ± 2.34) d.展开更多
Objective： to investigate the effect moxibustion on white blood cell amount and of Radi.r Astragali （ 黄芪 ） Injection and cellular immunity in patients with postchemotherapy leukopenia. Methods： eighty-six cases...Objective： to investigate the effect moxibustion on white blood cell amount and of Radi.r Astragali （ 黄芪 ） Injection and cellular immunity in patients with postchemotherapy leukopenia. Methods： eighty-six cases of post chemotherpy leucopenia were allocated into group of acupoint injection with Radix Astragali （黄芪） plus mild moxibustion with moxa stick（treatment group） and group of westerm medicine orally took（control group）, and the clinical symptoms, white blood cell amount, and the change of CD3^＋ , CD4^＋ and CD8^＋ before and after the treatment were observed. Results. acupoint injection with Radicc Astragali（黄芪） plus mild moxibustion with moxa stick could enhance the white blood cell amount more markedly than western medicine. The former could increase the contents of CD3^＋ and CD2^＋, and promote the ratio of CD4^＋ /CD^＋ of the patients with tumor, meanwhile, improve the general weak, and there is a significant different between the two groups（P〈 0.01）.展开更多
Objective： To investigate the effect of point injection on post-chemotherapeutic leukopenia. Methods： Three hundred patients were randomly divided into two groups. In the treatment group, 0.6 ml granulocyte colony s...Objective： To investigate the effect of point injection on post-chemotherapeutic leukopenia. Methods： Three hundred patients were randomly divided into two groups. In the treatment group, 0.6 ml granulocyte colony stimulating factor was injected into bilateral Xuehai （SP 10） and in the control group, the same dose subcutaneously into the deltoid muscle in the upper arm, once daily, three consecutive times as a course of treatment. A peripheral leukocyte count was examined at 3rd, 5th and 7th day after injection. Results and Conclusion： Under three courses of chemotherapy, therewas no significant difference in leukocyte increase between the two methods at 3rd and 5th day after treatment but a leukocyte count was significantly higher at 7th day in the treatment group than in the control group （P〈0.05）. After over half courses of chemotherapy, a peripheral leukocyte count was significantly higher in the treatment group than in the control group （P〈0.05） and it did not rise to the normal at 5-7 days after treatment in the control group. It is showed that point injection raised leukocyte quickly and kept the effect long in comparison with subcutaneous injection and the adverse responses were significantly less in the treatment group than in the control group.展开更多
Background White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons...Background White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated. We investigated patients with gastrointestinal fistula to find risk factors for leukopenia.Methods A prospective case control investigation was carried out in the Gastrointestinal Fistula Center, General Surgical Institute of Jinling Hospital. Cases included gastrointestinal fistula patients with leukopenia （n=98） and controls composed of gastrointestinal fistula patients with normal white blood cell count （n=78）. The two groups were compared for risk factors of leucopenia by statistical analysis.Results Factors associated with an increased risk for leukopenia included bacterial infection （25.5%） and hypoalbuminaemia （61.2%）. Multivariable Logistic regression analysis identified bacterial infection （80%）, urinary catheter （70%） and central vein catheter （60%） as the independent determinants for mortality in cases.Conclusions In patients with gastrointestinal fistula, two independent factors for leukopenia and three significant predictors of mortality were elucidated. We suggest that clinicians give patients more supportive management and apply prevention strategies to treat and prevent leukopenia.展开更多
The therapeutic effect of Fuzheng Compound, a Chinese herbal medicine, on leukocyte countin 59 patients with cancer of advanced stage atter chemotherapy or radiotherapy were observed. Among the41 cases of leukopenia, ...The therapeutic effect of Fuzheng Compound, a Chinese herbal medicine, on leukocyte countin 59 patients with cancer of advanced stage atter chemotherapy or radiotherapy were observed. Among the41 cases of leukopenia, leukocyte of 37 cases were normalized after treatment, the count pre- and post-treat-ment were ( 2 . 8 ± 0 . 6 ) x 109/L and ( 5 . 9 ± 1 . 5 ) x 109/L respectively ( P < 0 . 01 ) . In the 18 patients with nor-mal leukocyte count before treatment, the counts of 17 cases remained normal after treatment. The time forleukocyte recovering was 8. 0 days in average, while that of 23 patients who did not take Fuzheng Compoundwas 20. 6 ± 1 . 8 days. The results indicated that Fuzheng Compound could alleviate the inhibition of chemo- orradiotherapy on hemopoietic function of bone marrow and has leukcoytogenic effect.展开更多
Objective. To investigate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow proliferation. Methods.. Wister rats were selected to establish the leukopenia a...Objective. To investigate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow proliferation. Methods.. Wister rats were selected to establish the leukopenia and immuno-suppression model by intraperitoneal injection of cytoxan （CTX）. After they were grouped and treated, leukocyte and marrow karyocyte were counted in different phases to evaluate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow hematopoiesis. Results. Acupuncture or moxibustion at acupoint Geshu （BL 17） and routine western medicine could all significantly raise leukocyte and increase marrow karyocyte. The curative effect was better in moxibustion group than in acupuncture group and in routine western medicine group （P〈 0.05）. Conclusion. Moxibustion at acupoint Geshu （BL 17） can markedly raise peripheral blood leukocyte and marrow karyocyte of the leucopenia model in rats.展开更多
文摘BACKGROUND Cytomegalovirus(CMV)prophylaxis with valganciclovir and ganciclovir is associated with elevated neutropenia and leukopenia risk in kidney transplant recipients,although the impact of these events on healthcare resource utilization(HCRU)and clinical outcomes is unclear.AIM To quantify clinical events and HCRU associated with neutropenia and leukope-nia among adults receiving valganciclovir and/or ganciclovir post-kidney trans-plantation.METHODS Adult kidney transplant recipients receiving valganciclovir and/or ganciclovir prophylaxis were identified in the TriNetX database from 2012 to 2021.Patient characteristics were evaluated in the 1-year period pre-first transplant.HCRU and adjusted event rates per person-year were evaluated in follow-up year 1 and years 2-5 after first kidney transplantation among cohorts with vs without neutropenia and/or leukopenia.RESULTS Of 15398 identified patients,the average age was 52.39 years and 58.70%were male.Patients with neutropenia and/or leukopenia had greater risk of clinical events for CMV-related events,opportunistic infections,use of granulocyte colony stimulating factor,and hospitalizations(relative risk>1 in year 1 and years 2-5).Patients with vs without neutropenia and/or leukopenia had higher HCRU in year 1 and years 2-5 post kidney transplantation,including the mean number of inpatient admissions(year 1:3.47 vs 2.76;years 2-5:2.70 vs 2.29)and outpatient visits(48.97 vs 34.42;31.73 vs 15.59,respectively),as well as the mean number of labs(1654.55 vs 1182.27;622.37 vs 327.89).CONCLUSION Adults receiving valganciclovir and/or ganciclovir prophylaxis post-kidney transplantation had greater risk of neutropenia and/or leukopenia,which were associated with higher clinical event rates and HCRU up to 5 years post-transplantation.These findings suggest the need for alternative prophylaxis options with lower myelosup-pressive effects to improve patient outcomes.
基金Supported by The Qihuang Scholars Support Program of the National Administration of Traditional Chinese Medicinet:2021 Qihuang Scholars Support Project(National Chinese Medicine Teaching Letter[2022]6)National Traditional Medicine Administration's Project for Establishing National Famous and Elderly Traditional Medicine Transmission Workshops:Xie Yanming National Famous Traditional Chinese Medicine Expert Transmission Studio(National Chinese Medicine Education Letter[2022]75)。
文摘OBJECTIVE:To systematically assess the safety and effectiveness of Compound E’jiao Jiang(复方阿胶浆,CEJ)for treating leukopenia.METHODS:Four English and four Chinese databases were searched for randomized controlled trials(RCTs)on CEJ for treating leukopenia up to July 1,2024.Two researchers independently screened the studies and extracted necessary data.Methodological quality and risk of bias were assessed using the Cochrane risk-of-bias tool.Articles eligible for Meta-analysis were analyzed using RevMan.RESULTS:A total of 28 RCTs involving 2041 participants were included,with 1034 in the experimental group and 1007 in the control group.The Meta-analysis showed a significant effect of CEJ in treating leukopenia caused by tumor and immune diseases(three RCTs)[risk ratio(RR)=1.17,95%confidence interval(CI)(1.08,1.27),P=0.0002,I^(2)=35%].The combination of CEJ and Western Medicine showed superior results in terms of white blood cell(WBC)counts(fifteen RCTs)[mean difference(MD)=1.12,95%CI(0.83,1.42),P<0.00001,I^(2)=88%],Karnofsky Performance Status(KPS)levels(seven RCTs)[RR=1.39,95%CI(1.25,1.55),P<0.00001,I^(2)=36%],and mitigation of bone marrow toxicity(eleven RCTs)[RR=0.61,95%CI(0.54,0.69),P<0.00001,I^(2)=24%]compared to Western Medicine alone.Adverse events mainly included gastrointestinal and digestive reactions associated with chemotherapy drugs.CONCLUSION:CEJ alone or in combination with Western Medicine for treating leukopenia caused by tumor and immune diseases improved WBC counts,clinical efficacy,and quality of life.It also reduced bone marrow toxicity-induced leukopenia,enhanced the efficacy of chemotherapy while reducing its toxicity,and alleviated symptoms.No significant adverse events were reported in the RCTs,indicating favorable efficacy and safety.The Grading of Recommendations Assessment,Development and Evaluation assessment indicated a low level of evidence for CEJ in improving leukocyte elevation efficacy,KPS levels,and myelosuppressive toxicity.Therefore,large-scale,high-quality,rigorous multicenter double-blind controlled trials are recommended to strengthen the evidence level.
基金Supported by the National Natural Science Foundation of China,No.81573507,No.81473283,No.81173131,and No.81320108027Guangdong Provincial Key Laboratory Construction Foundation,No.2017B030314030+1 种基金The National Key Research and Development Program,No.2016YFC0905003the 111 Project,No.B16047
文摘BACKGROUND Thiopurine-induced leukopenia(TIL)is a life-threatening toxicity and occurs with a high frequency in the Asian population.Although nucleoside diphosphate-linked moiety X-type motif 15(NUDT15)variants significantly improve the predictive sensitivity of TIL,more than 50%of cases of this toxicity cannot be predicted by this mutation.The potential use of the 6-thioguanine nucleotide(6TGN)level to predict TIL has been explored,but no decisive conclusion has been reached.Can we increase the predictive sensitivity based on 6TGN by subgrouping patients according to their NUDT15 R139C genotypes?AIM To determine the 6TGN cut-off levels after dividing patients into subgroups according to their NUDT15 R139C genotypes.METHODS Patients’clinical and epidemiological characteristics were collected from medical records from July 2014 to February 2017.NUDT15 R139C,thiopurine S methyltransferase,and 6TGN concentrations were measured.RESULTS A total of 411 Crohn’s disease patients were included.TIL was observed in 72 individuals with a median 6TGN level of 323.4 pmol/8×10^8 red blood cells(RBC),which was not different from that of patients without TIL(P=0.071).Then,we compared the 6TGN levels based on NUDT15 R139C.For CC(n=342)and CT(n=65)genotypes,the median 6TGN level in patients with TIL was significantly higher than that in patients without(474.8 vs 306.0 pmol/8×10^8 RBC,P=9.4×10-^5;291.7 vs 217.6 pmol/8×10^8 RBC,P=0.039,respectively).The four TT carriers developed TIL,with a median 6TGN concentration of 135.8 pmol/8×10^8 RBC.The 6TGN cut-off levels were 411.5 and 319.2 pmol/8×108 RBC for the CC and CT groups,respectively.CONCLUSION The predictive sensitivity of TIL based on 6TGN is dramatically increased after subgrouping according to NUDT15 R139C genotypes.Applying 6TGN cut-off levels to adjust thiopurine therapies based on NUDT15 is strongly recommended.
基金supported by the Key Problem Tackling Project for Cancer Therapy, China (Grant No. 12ZCDZSY15600)
文摘Objective: Chemotherapy is the standard treatment for small-cell lung cancer (SCLC), and leukopenia is a common side effect. This study assesses whether chemotherapy-induced leukopenia is a predictor of efficacy and whether it is associated with the survival of SCLC patients. Methods: A retrospective analysis was conducted on data from 445 patients with SCLC who received standard chemotherapy for 4 to 10 cycles. The World Health Organization grading system classifies leukopenia during chemotherapy as follows: absent (grade 0), mild (grades 1 and 2), or severe (grades 3 and 4). The primary endpoint is overall survival (OS). Results: The association between chemotherapy-induced leukopenia and OS was assessed. According to a multivariate Cox model with time-varying covariates, the hazard ratio of death was significantly lower among patients with mild leukopenia than among patients with severe leukopenia at 0.687 (0.506 to 0.943) and 1.414 (1.147 to 1.744), respectively. The median survival was 13 months (95% CI: 11 to 15 months) for patients who did not experience leukopenia, 17 months (95% CI: 14 to 18 months) for those with mild leukopenia, and 14 months (95% CI: 13 to 16 months) for those with severe leukopenia (absent vs. mild vs. severe leukopenia, P=0.047). Conclusion: Leukopenia during chemotherapy is associated with the survival of SCLC patients. Mild leukopenia is strongly associated with longer survival time.
文摘Objective： To evaluate the efficacy and safety of sodium copper chlorophyllin （trademarked as ＂Yebaike Tablet （叶拜克） which is abbreviated as YBK in treating leukopenia. Methods： One hundred and five patients with leukopenia caused by various factors were randomized into 3 groups. The 60 patients in the YBK group took orally YBK Tablets at the dose of 40 mg, three times per day, the 30 patients in the leucogen group were treated with Leucogen Tablets （利血生片） at the dose of 20 mg, three times per day, and the 15 patients in the placebo group were administered with vitamin C tablets 100 mg, three times per day. All the subjects were treated for 1 month. The change of peripheral leucocytes count after treatment and adverse drug reaction that occurred in patients were studied. Results： In the 60 patients treated with YBK, the treatment proved to be markedly effective in 34 cases, effective in 17 and ineffective in 9, the total effective rate being 85%, which was significantly higher than that in the placebo group （26.7%, P〈0.01） and similar to that in the leucogen group （83.3 %, P〉0.05）. No adverse reaction was found in the treatment course. Conclusion： YBK can be used in the treatment of leukopenia caused by various factors, satisfactory in efficacy and safe in use.
文摘AIM: To investigate the clinical impact of post-hyperthermic intraperitoneal chemotherapy(HIPEC) leukopenia, intraperitoneal and combined intravenous/intraperitoneal drug administrations were compared.METHODS: Two patient cohorts were retrospectively analyzed regarding the incidence of postoperative leukopenia. The first cohort(n = 32) received Mitomycin C(MMC)-based HIPEC intraperitoneally(35 mg/m2 for 90 min) and the second cohort(n = 10) received a bidirectional therapy consisting of oxaliplatin(OX)(300 mg/m2 for 30 min) intraperitoneally and 5-fluorouracil(5-FU) 400 mg/m2 plus folinic acid 20 mg/m2 intravenously. The following data were collected retrospectively: Age, sex, length of operation, length of hospital stay, amount of resection including extent of peritonectomy, peritoneal cancer index, CC(completeness of cytoreduction)-status and leukocyte-count before cytoreductive surgery(CRS) and HIPEC, on days 3, 7 and 14 after CRS and HIPEC. HIPEC leukopenia was defined as < 4000 cells/m3. RESULTS: Leukopenia occurred statistically more often in the MMC than in the OX/5-FU-group(10/32 vs 0/10; P = 0.042). Leukopenia set-on was on day 7 after CRS and MMC-HIPEC and lasted for two to three days. Three patients(33%) required medical treatment. Patients affected by leukopenia were predominantly female(7/10 patients) and older than 50 years(8/10 patients). Thelength of hospital stay tended to be higher in the MMCgroup without reaching statistical significance(22.5± 11 vs 16.5 ± 3.5 d). Length of operation(08:54 ± 01:44 vs 09:48 ± 02:28 h) were comparable between patients with and without postoperative leukopenia. Prior history of systemic chemotherapy did not trigger postHIPEC leukopenia. Occurrence of leucopenia did not trigger surgical site infections, intraabdominal abscess formations, hospital-acquired pneumonia or anastomotic insufficiencies. CONCLUSION: Surgeons must be aware that there is a higher incidence of postoperative leukopenia in MMCbased HIPEC protocols primarily affecting females and older patients.
文摘In recent years, leukopenia is clinically very common. The leukopenic patient is significantly low in immunocompetence and is likely to suffer from various kinds of infections. Zusanli (St 36), an
文摘From April 1992 to April 1998, 104 cases of chemotherapy-induced leukopenia were treated by injection into Zusanli (ST 36) with a mixture consisting of dexamethasone, 654-2, ATP and inosine. The therapeutic results were satisfactory as reported in the following.Clinical Data In this series, all the 127 cases were definitely diagnosed by pathological examination. Of them, 93 were male and 34 female, ranging in age from 12 to 75 years. 38 cases were carcinoma of esophagus, 22 carcinoma of cardia of stomach, 21 cancer of lung, 11 hepatic carcinoma, 8 lymphoma, 8 mammary cancer, 7 carcinoma of colon, and 12 other kinds of the tumors. Leukocyte count was below 4.0×109/L in all the patients after being treated by chemotherapy.
基金Supported by the 2022 Nanjing Health Science and Technology Development Special Fund Support Project,No.YKK22240.
文摘BACKGROUND Thrombocytopenia is a common complication of invasive liver abscess syndrome(ILAS)by Klebsiella pneumoniae(K.pneumoniae)infection,which indicates severe infection and a poor prognosis.However,the presence of leukopenia is rare.There are rare reports on leukopenia and its clinical significance for ILAS,and there is currently no recognized treatment plan.Early and broad-spectrum antimi-crobial therapy may be an effective therapy for treating ILAS and improving its prognosis.CASE SUMMARY A 55-year-old male patient who developed fever,chills,and abdominal distension without an obvious cause presented to the hospital for treatment.Laboratory tests revealed thrombocytopenia,leukopenia,and multiple organ dysfunction.Imaging examinations revealed an abscess in the right lobe of the liver and thromboph-lebitis,and K.pneumoniae was detected in the blood cultures.Since the patient was diabetic and had multi-system involvement,he was diagnosed with ILAS accom-panied by leukopenia and thrombocytopenia.After antibiotic treatment and sys-temic supportive therapy,the symptoms disappeared,and the patient’s condition almost completely resolved.CONCLUSION Leukopenia is a rare complication of ILAS,which serves as an indicator of adverse prognostic outcomes and the severity of infection.
文摘ACPRs of leukopenia in peripheral blood of workers exposed to benzene in small-scale industries are calculated using capture-recapture methods. The results from two figures with 6-month apart demonstrate that the ACPR in workers exposed to benzene is 36.81(29. 14-44.48)%, significantly higher than that of control 12.71(7.20-18.22)% (P<0.05),with a relative risk of 2.9. The prevalences of 4 cross-sectional investigations in exposure group calculated with routine method are 18.73%, 26.37%, 27.93%, and 36.76% respectively;in controls, 8.38%, 6.85%, 7.94%, and 15.00% respectively and all fall in the range of 95% CI of ACPR. It is suggested that the methods of calculating ACPR by capture-recapture methods is simple, feasible and efficient, with the results more precise than with traditional methods.
文摘Objective: to treat leukemia patients with chemotherapy with leukemia reduction symptoms with left supplemented myeloid blood soup and analyze its effect. Methods: a total of 82 patients were selected by double-blind method, including conventional treatment (group A) and left supplementary pulp blood soup (group B), to compare the effects of different treatment methods. Results: comparison with Group A, Group B had a significant curative effect (P <0.05);Group B WBC (leukocyte count), Hb (hemoglobin), GRA (neutrophil count), and PLT (platelet count) were (4.65 ± 0.51) 109 / L, (132.52 ± 16.35) g / L, (3.78 ± 0.52) 109 / L, (195.46 ± 11.52) 109 / L were all higher than Group A (3.65 ± 0.55) 109 / L, (115.63 ± 16.52) g / L, (2.56 ± 0.5) 109 / L, (118.62 ± 11. 32)×109/L(P<0.05);In Group B, the soluble intercell adhesion molecule-1 (sICAM-1) and serum superoxide dismutase (SOD) were (265.35 ± 76.25) ng/mL, (331.65 ± 45.74) μg/L were higher than the (400.32 ± 99.32) ng/mL, and (281.25 ± 45.26) μg/L in Group A, Serotransformed growth factor-1 (TGF-1), lipid peroxide (LPO) were (32.65 ± 6.25) ng/mL, (1.51 ± 0.42) μmol/L were lower than (16.53 ± 5.23) ng/mL, and (1.85 ± 0.43) μmol/L (P <0.05);Group A dizziness, less food and fatigue were (1.06 ± 0.55), (1.23 ± 0.55), (1.33 ± 0.36) were all below (3.02 ± 0.56), (2.85 ± 0.52), (2.65 ± 0.41) (P <0.05);There was no difference in the adverse effects between the two groups (P> 0.05).To observe the clinical efficacy of left myeloid blood soup for leukopenia after leukemia chemotherapy;Methods: 42 patients with leukopenia after leukemia chemotherapy were randomly divided into treatment group and control group. 21 patients in each group were treated with oral squalshark hepatol and vitamin B4 tablets based on oral shark hepatol tablets and vitamin B4 tablets. The result was 80.95%, 42.85% (P0.05);Conclusion: It had obvious effect on leukopenia after leukemia chemotherapy. Conclusion: the treatment of left supplementary pulp blood soup can significantly improve the number of white blood cells in patients, promote the recovery of various symptoms, and significantly improve the patient's condition. There were 13 infections during treatment, average antibiotic time (7.01 ± 2.34) d.
文摘Objective： to investigate the effect moxibustion on white blood cell amount and of Radi.r Astragali （ 黄芪 ） Injection and cellular immunity in patients with postchemotherapy leukopenia. Methods： eighty-six cases of post chemotherpy leucopenia were allocated into group of acupoint injection with Radix Astragali （黄芪） plus mild moxibustion with moxa stick（treatment group） and group of westerm medicine orally took（control group）, and the clinical symptoms, white blood cell amount, and the change of CD3^＋ , CD4^＋ and CD8^＋ before and after the treatment were observed. Results. acupoint injection with Radicc Astragali（黄芪） plus mild moxibustion with moxa stick could enhance the white blood cell amount more markedly than western medicine. The former could increase the contents of CD3^＋ and CD2^＋, and promote the ratio of CD4^＋ /CD^＋ of the patients with tumor, meanwhile, improve the general weak, and there is a significant different between the two groups（P〈 0.01）.
文摘Objective： To investigate the effect of point injection on post-chemotherapeutic leukopenia. Methods： Three hundred patients were randomly divided into two groups. In the treatment group, 0.6 ml granulocyte colony stimulating factor was injected into bilateral Xuehai （SP 10） and in the control group, the same dose subcutaneously into the deltoid muscle in the upper arm, once daily, three consecutive times as a course of treatment. A peripheral leukocyte count was examined at 3rd, 5th and 7th day after injection. Results and Conclusion： Under three courses of chemotherapy, therewas no significant difference in leukocyte increase between the two methods at 3rd and 5th day after treatment but a leukocyte count was significantly higher at 7th day in the treatment group than in the control group （P〈0.05）. After over half courses of chemotherapy, a peripheral leukocyte count was significantly higher in the treatment group than in the control group （P〈0.05） and it did not rise to the normal at 5-7 days after treatment in the control group. It is showed that point injection raised leukocyte quickly and kept the effect long in comparison with subcutaneous injection and the adverse responses were significantly less in the treatment group than in the control group.
基金This work was supported by the National Natural Science Foundation of China （Grant No. 30872456）.
文摘Background White blood cell count is an important index to the outcome of patients. In hospital, leukopenia is accompanied by high mortality, morbidity and treatment costs. However, in infectious diseases, the reasons responsible for leucopenia was not well elucidated. We investigated patients with gastrointestinal fistula to find risk factors for leukopenia.Methods A prospective case control investigation was carried out in the Gastrointestinal Fistula Center, General Surgical Institute of Jinling Hospital. Cases included gastrointestinal fistula patients with leukopenia （n=98） and controls composed of gastrointestinal fistula patients with normal white blood cell count （n=78）. The two groups were compared for risk factors of leucopenia by statistical analysis.Results Factors associated with an increased risk for leukopenia included bacterial infection （25.5%） and hypoalbuminaemia （61.2%）. Multivariable Logistic regression analysis identified bacterial infection （80%）, urinary catheter （70%） and central vein catheter （60%） as the independent determinants for mortality in cases.Conclusions In patients with gastrointestinal fistula, two independent factors for leukopenia and three significant predictors of mortality were elucidated. We suggest that clinicians give patients more supportive management and apply prevention strategies to treat and prevent leukopenia.
文摘The therapeutic effect of Fuzheng Compound, a Chinese herbal medicine, on leukocyte countin 59 patients with cancer of advanced stage atter chemotherapy or radiotherapy were observed. Among the41 cases of leukopenia, leukocyte of 37 cases were normalized after treatment, the count pre- and post-treat-ment were ( 2 . 8 ± 0 . 6 ) x 109/L and ( 5 . 9 ± 1 . 5 ) x 109/L respectively ( P < 0 . 01 ) . In the 18 patients with nor-mal leukocyte count before treatment, the counts of 17 cases remained normal after treatment. The time forleukocyte recovering was 8. 0 days in average, while that of 23 patients who did not take Fuzheng Compoundwas 20. 6 ± 1 . 8 days. The results indicated that Fuzheng Compound could alleviate the inhibition of chemo- orradiotherapy on hemopoietic function of bone marrow and has leukcoytogenic effect.
文摘Objective. To investigate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow proliferation. Methods.. Wister rats were selected to establish the leukopenia and immuno-suppression model by intraperitoneal injection of cytoxan （CTX）. After they were grouped and treated, leukocyte and marrow karyocyte were counted in different phases to evaluate the effect of acupuncture or moxibustion at acupoint Geshu （BL 17） on raising leukocyte and promoting marrow hematopoiesis. Results. Acupuncture or moxibustion at acupoint Geshu （BL 17） and routine western medicine could all significantly raise leukocyte and increase marrow karyocyte. The curative effect was better in moxibustion group than in acupuncture group and in routine western medicine group （P〈 0.05）. Conclusion. Moxibustion at acupoint Geshu （BL 17） can markedly raise peripheral blood leukocyte and marrow karyocyte of the leucopenia model in rats.
