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Medical Oncology and Tumor Pharmacotherapy

, Volume 6, Issue 4, pp 291–296 | Cite as

Combination of pipemidic acid, colistin sodium methanesulfonate and nystatin may be less effective than nystatin alone for prevention of infection during chemotherapy-induced granulocytopenia in acute leukemia

  • Kazumi Sampi
  • Masaharu Sakurai
  • Ryoji Kumai
  • Nobuo Maseki
  • Yasuhiko Kaneko
  • Masao Hattori
Original Articles
  • 17 Downloads

Abstract

Pipemidic acid (PPA) and colistin sodium methanesulfonate (CLM) may selectively suppress aerobic gramnegative bacilli. Twenty-nine patients with acute leukemia were randomized after each course of consolidation chemotherapy to receive a single agent of nystatin (NYS) (34 courses) versus a combination of NYS, PPA and CLM (36 courses). The duration of fever over 39°C was longer with the three drug combination (4.6 ± 5.1 days) than with NYS alone (1.8 ± 1.8 days) (P < 0.01). Four cases of pneumonia occurred and four patients inclucling one having pneumonia died of infection with the three drug combination, while no pneumonia or death occurred with NYS alone (P = 0.06 andP = 0.06, respectively). The combination of NYS, PPA and CLM may be less effective than NYS alone for the prevention of infection in acute leukemia patients with chemotherapy-associated granulocytopenia.

Key words

Acute leukemia Prevention of infection Gut decontamination Pipemidic acid Colistin sodium methanesulfonate Nystatin 

Abbreviations used in this paper

PPA

pipemidic acid

CLM

colistin sodium methanesulfonate

NYS

nystatin ara-C, cytarabine

HDARA-C

high dose ara-C

DNR

daunorubicin

DHAD

mitoxantrone

ACR

aclarubicin

ANLL

acute nonlymphocytic leukemia

ALL

acute lymphocytic leukemia

GVN

gentamicin, vancomycin and nystatin

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Copyright information

© Humana Press Inc. 1989

Authors and Affiliations

  • Kazumi Sampi
    • 1
  • Masaharu Sakurai
    • 2
  • Ryoji Kumai
    • 1
  • Nobuo Maseki
    • 1
  • Yasuhiko Kaneko
    • 3
  • Masao Hattori
    • 1
  1. 1.HematoIogy ClinicSaitama Cancer Center HospitalSaitamaJapan
  2. 2.Department of Cancer ChemotherapySaitama Cancer Center HospitalSaitamaJapan
  3. 3.Department of Laboratory MedicineSaitama Cancer Center HospitalSaitamaJapan

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