Rinku General Medical Center 4860 100 1620
Ann Intern Med. 1966; 64: 328 40 CHOP 63 1 83 J Clin Oncol. 1998; 16: 20065-69
Febrile Neutropenia IDSA(Infectious Diseases Society of America) 2002 Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer
a 60 b 21 a 1 b 16 100/mm3 X J Clin Oncol 2000 ; 28 : 3038-51 FN N72 N13 N20 N26 N13 11(855(2520(779(69 2(156(30 5(194(31 0 a 9(45 b 1(40 c a
(%) () 4.0 25 MSSA ND 47.6 21 MRSA 10.2 15.2 46 3.0 53.6 28 1.7 40.0 10 NF-GNR 3.8 40.0 20 5.5 7.8 38.5 26 5.1 30.8 208 50 40 30 20 10 0 0 5 10 A 7-14 31 11(35) 12(39) 8(26) B 15-16 34 20(59) 8(24) 6(18) C 17-18 53 35(66) 9(17) 9(17) D 19-20 63 43(68) 12(19) 8(13) Total 109 41 31
or or or or or + (38.3) 1 (500/mm 3 ) 2 IDSA(Infectious Diseases Society of America) 2002 Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer 2 2 3 3~5
3~5 ( ) IDSA(Infectious Diseases Society of America) 2002 Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer 500/ 45 500/ 23 3~5 3~5 B 5~7 IDSA(Infectious Diseases Society of America) 2002 Guidelines for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer
Randomized Trial of CFPM Monotherapy or CFPM in Combination with AMK as Empirical Therapy for FN. Clin Infect Dis. 2004; 39:S15 24 Table 5. Clinical response according to baseline neutrophil count among pts in the 2 treatment arms. No (%) of patients with response, by day after initiation of therapy and baseline neutrophil count Day 3 Day 7 Treatment arm, outcome CFPM Effective Not effective Subtotal CFPM+AMK Effective Not effective Subtotal All patients Effective Not effective Subtotal 500 cells/l 21 (27.6)a 21 ( 55 (72.4) 76 (100) 36 (45.0)e 36 ( 44 (55.0) 80 (100) 57 (36.5) 99 (63.5) 156 (100) 500 cells/l 10 (52.6)b 10 ( 9 (47.4) 19 (100) 7 (50.0)f 7 (50.0) 14 (100) 17 (51.5) 16 (48.5) 33 (100) Subtotal 31 (32.6) 64 (67.4) 95 (100) 43 (45.7) 51 (54.3) 94 (100) 74 (39.2) 115 (60.8) 189 (100) P values are as follows: a vs. b, P=0.038 ; a vs. e, P=0.024 500 cells/l 48 (63.2)c 28 (36.8) 76 (100) 60 (75.0)g 20 (25.0) 80 (100) 108 (70.1) 48 (29.9) 156 (100) 500 cells/l 13 (68.4)d 6 (31.6) 19 (100) 12 (85.7)h 2 (14.3) 14 (100) 25 (75.8) 8 (24.2) 33 (100) Subtotal 61 (64.2) 34 (35.8) 95 (100) 72 (76.6) 22 (23.4) 94 (100) 133 (78.8) 56 (21.2) 189 (100) 2004 50 81-87 4.9 4.0 0.013
/ 1 or 33 or Clinical Infectious Diseases 2004:39 (Supple1)
-D Clinical Infectious Diseases 2004:39;199-205 - Clinical Infectious Diseases 2004:39;199-205
ELISA) British Journal of Haematology :126: 852-860 British Journal of Haematology :126: 852-860
B Clin Infect Dis. 2004; 39:S38 43
EX DNR VCR PSL L-Asp WBC / Blast 経過 1 Imatinib G-CSF Neutropenic fever CHF IPA (9/11) (9/24) (10/4) (10/9) (10/13) 肺アスペルギルス症 ( 画像 )
(WBC) AMPH-B 経過 2 Imatinib MCFG IPA (CRP) (10/15) (11/13) (12/10) (2/21) (3/12)
Rate,% OR(95% CI) P 3.47(2.27-5.31).001 3.86(2.46-6.07) 2.47(1.42-4.27) 1.59(1.06-2.40) 2.03(1.29-3.19) 1 1 1 1.001.001.03 1.62(1.00-2.61).05 1 1.86(1.25-2.78).002 1.002 Rate,% OR(95% CI) P ( ) ( ) 3.47(2.27-5.31).001 3.54(2.07-6.05) 5.12(2.70-9.73) 2.09(1.27-3.42) 0.87(0.52-1.46) 1 1 1 1.001.001.004.60
)
1991 325 167 1991 325 167
- 1997 336 1778-2001 93 35-2000 96 83-2004 90 1304-2003 39 2267
2001 91 2246-57 - 2000 20 104-14
Clin Infect Dis. 2004; 39:S25 31
2004 33 847-53 2004 33 847-53
Clin Infect Dis. 1996; 23:795-805 - - + - 2
pg/ml
Rev Infect Dis. 1990 Nov-Dec;12(6):1147-201. retrospective / Clin Infect Dis. 1998 May;26(5):1098-103.
-12Hr 0
ClinicalCourse British Journal of Haematology 2004 :127: 501-508
British Journal of Haematology 2004 :127: 501-508 Oncology Nursing Forum, 2004 ; 31: 4: 717-25
+
ESHAP 300mg 200mg~400mg 3g NSAIDS