Treatment schedule with an immunoglobulin preparation against fever in granulocytopenic patients with hematological malignancies

Patients with hematological malignancies, who were clinically suspected of having sepsis after developing granulocytopenia and a fever of 38°C or higher following anti-cancer chemotherapy, were divided into Group A and Group B by an envelope method. Group A received antibacterial agents (piperacilli...

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Published inJapanese Journal of Chemotherapy Vol. 44; no. 11; pp. 853 - 857
Main Authors Mori, Kei, Hamada, Kaoru, Imae, Norihisa, Mikasa, Keiichi, Sakamoto, Masahiro, Teramoto, Shoji, Yamanaka, Takayo, Tsujimoto, Masayuki, Maeda, Koichi, Nishikawa, Kiyoshi, Sawaki, Masayoshi, Narita, Nobuhiro, Konishi, Mitsuru
Format Journal Article
LanguageJapanese
Published Japanese Society of Chemotherapy 1996
公益社団法人 日本化学療法学会
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ISSN1340-7007
1884-5886
DOI10.11250/chemotherapy1995.44.853

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Abstract Patients with hematological malignancies, who were clinically suspected of having sepsis after developing granulocytopenia and a fever of 38°C or higher following anti-cancer chemotherapy, were divided into Group A and Group B by an envelope method. Group A received antibacterial agents (piperacillin: PIPC+isepamicin: ISP) and an immunoglobulin preparation (Polyglobin N®) simultaneously. Group B received antibacterial agents (PIPC+ISP) first and an immunoglobulin preparation 4 days later. The clinical courses of both groups were compared. There were no significant differences between Group A (10 cases) and Group B (11 cases) in underlying diseases and leukocyte count, granulocyte count, CRP or use of CSF preparations at the fever onset. In Group A, decline of fever and improvement of CRP were significantly quicker compared to those in Group B. Recovery of the leukocyte count was also significantly faster in Group A than in Group B. The treatment period with the antibacterial agents was significantly shortened in Group A compared with Group B. Though GOT and GPT were elevated slightly in one case of Group A, no severe adverse reaction was seen in both groups. These results demonstrate the possibility that an early injection of immunoglobulin preparations is effective for the treatment of granulocytopenic infections in patients with hematological malignancies.
AbstractList Patients with hematological malignancies, who were clinically suspected of having sepsis after developing granulocytopenia and a fever of 38°C or higher following anti-cancer chemotherapy, were divided into Group A and Group B by an envelope method. Group A received antibacterial agents (piperacillin: PIPC+isepamicin: ISP) and an immunoglobulin preparation (Polyglobin N®) simultaneously. Group B received antibacterial agents (PIPC+ISP) first and an immunoglobulin preparation 4 days later. The clinical courses of both groups were compared. There were no significant differences between Group A (10 cases) and Group B (11 cases) in underlying diseases and leukocyte count, granulocyte count, CRP or use of CSF preparations at the fever onset. In Group A, decline of fever and improvement of CRP were significantly quicker compared to those in Group B. Recovery of the leukocyte count was also significantly faster in Group A than in Group B. The treatment period with the antibacterial agents was significantly shortened in Group A compared with Group B. Though GOT and GPT were elevated slightly in one case of Group A, no severe adverse reaction was seen in both groups. These results demonstrate the possibility that an early injection of immunoglobulin preparations is effective for the treatment of granulocytopenic infections in patients with hematological malignancies.
Patients with hematological malignancies, who were clinically suspected of having sepsis after developing granulocytopenia and a fever of 38°C or higher following anti-cancer chemotherapy, were divided into Group A and Group B by an envelope method. Group A received antibacterial agents (piperacillin: PIPC+isepamicin: ISP) and an immunoglobulin preparation (Polyglobin N®) simultaneously. Group B received antibacterial agents (PIPC+ISP) first and an immunoglobulin preparation 4 days later. The clinical courses of both groups were compared. There were no significant differences between Group A (10 cases) and Group B (11 cases) in underlying diseases and leukocyte count, granulocyte count, CRP or use of CSF preparations at the fever onset. In Group A, decline of fever and improvement of CRP were significantly quicker compared to those in Group B. Recovery of the leukocyte count was also significantly faster in Group A than in Group B. The treatment period with the antibacterial agents was significantly shortened in Group A compared with Group B. Though GOT and GPT were elevated slightly in one case of Group A, no severe adverse reaction was seen in both groups. These results demonstrate the possibility that an early injection of immunoglobulin preparations is effective for the treatment of granulocytopenic infections in patients with hematological malignancies. 血液悪性疾患の抗癌化学療法後の顆粒球減少時に38℃ 以上の発熱を認め, Boneによる敗血症の診断基準を満たし, 臨床的に敗血症を疑った症例を抗菌薬 (piperacillin: PIPC+isepamicin: ISP) と同時に免疫グロプリン製剤 (ポリグロビンN®) を投与する群 (A群) と抗菌薬 (PIPC+ISP) 投与後4日目から免疫グロブリン製剤を投与する群 (B群) とに封筒法で分け, 臨床経過を比較検討した。A群 (10例) とB群 (11例) とには基礎疾患, 発熱時の白血球数・顆粒球数・CRP・colony-stimulating factor (CSF) 製剤の使用に有意差はなかった。A群ではB群に比較し, 解熱・CRPの改善と白血球数の回復とが有意に早く, 抗菌薬の投与期間が有意に短縮した。A群の1例でGOT・GPTの軽度上昇を認めたが, 重篤な副作用は両群ともなかった。以上から血液悪性疾患では顆粒球減少時の感染症治療上免疫グロプリン製剤を早期から投与することが有用である可能性が示唆された。
Author Sakamoto, Masahiro
Mori, Kei
Sawaki, Masayoshi
Narita, Nobuhiro
Tsujimoto, Masayuki
Nishikawa, Kiyoshi
Imae, Norihisa
Yamanaka, Takayo
Maeda, Koichi
Konishi, Mitsuru
Hamada, Kaoru
Teramoto, Shoji
Mikasa, Keiichi
Author_FL 前田 光一
山中 貴世
井前 徳久
三笠 桂一
森 啓
成田 亘啓
坂本 正洋
濱田 薫
西川 潔
澤木 政好
寺本 正治
辻本 正之
古西 満
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  fullname: Konishi, Mitsuru
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References 7) Bone R C, Fein A M, Balk R A, Knaus W A, Cerra F B, Schein R M H, Dellinger R P, Sibbld W J: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101: 1644-1655, 1992
2) 佐々木安津子, 塚口真知子: 造血器疾患患者の死因について-特に敗血症と真菌感染について. 現代医療25 (増刊): 3007-3011, 1993
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6) Harper T E, Christensen R D, Rothstein G, Hill H R: Effect of intravenous immunoglobulin G on neutrophil kinetics during experimental Group G Streptococcul infection in neonatal rats. Rev Infect Dis 8: S 401-S 408, 1986
3) 北村聖, 高久史麿, 宮崎保, 涌井昭, 溝口秀昭, 内野治人, 正岡徹, 永井清保, 仁保喜之: 内科領域の重症感染症に対する静注用液状人免疫グロブリン製剤C-425の抗生剤との併用効果. 感染症誌64: 19-33, 1990
References_xml – reference: 3) 北村聖, 高久史麿, 宮崎保, 涌井昭, 溝口秀昭, 内野治人, 正岡徹, 永井清保, 仁保喜之: 内科領域の重症感染症に対する静注用液状人免疫グロブリン製剤C-425の抗生剤との併用効果. 感染症誌64: 19-33, 1990
– reference: 5) 高橋弘, 草剪博昭, 中澤省三: 脳神経外科領域の重症感染症における免疫グロブリン製剤と抗生物質との併用効果-投与スケジュールの違いによる効果の比較検討-. 感染症誌68: 767-774, 1994
– reference: 8) 長部誠志: 造血器腫瘍における敗血症の実態-監視培養の有用性と危険因子解析-. Chemotherapy 43: 539-546, 1995
– reference: 6) Harper T E, Christensen R D, Rothstein G, Hill H R: Effect of intravenous immunoglobulin G on neutrophil kinetics during experimental Group G Streptococcul infection in neonatal rats. Rev Infect Dis 8: S 401-S 408, 1986
– reference: 2) 佐々木安津子, 塚口真知子: 造血器疾患患者の死因について-特に敗血症と真菌感染について. 現代医療25 (増刊): 3007-3011, 1993
– reference: 4) 北村聖, 溝口秀昭, 平嶋邦猛, 浅野茂隆, 外山圭助, 池田康夫, 高久史麿: 内科領域の重症感染症に対する人免疫グロブリン, 抗生剤とG-SCFとの併用効果. 感染症誌69: 684-695, 1995
– reference: 7) Bone R C, Fein A M, Balk R A, Knaus W A, Cerra F B, Schein R M H, Dellinger R P, Sibbld W J: Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 101: 1644-1655, 1992
– reference: 1) 金森平和, 他: 血液疾患に合併した敗血症の検討. 臨床血液30: 158-163, 1989
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Snippet Patients with hematological malignancies, who were clinically suspected of having sepsis after developing granulocytopenia and a fever of 38°C or higher...
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SubjectTerms グロブリン製剤
投与時期
敗血症
血液悪性疾患
顆粒球減少
Title Treatment schedule with an immunoglobulin preparation against fever in granulocytopenic patients with hematological malignancies
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