Günther I, Kaben U, Dunker H, Brijmohan-Günther R, Konrad H
Abteilung für Hämatologie, Wilhelm-Pieck-Universität, Rostock, GDR.
Recent Results Cancer Res. 1988;108:82-8. doi: 10.1007/978-3-642-82932-1_11.
For prevention of infection we used an SD design including antibacterial (trimethoprim 480 mg/daily, sulfamerazine 720 mg/daily, and polymyxin 0.25 mg/daily) and antifungal (4-6 million IU nystatin/daily) components. We analyzed retrospectively 138 treatment periods in 108 patients. The intensified chemotherapy resulted in severe granulocytopenia below 0.1 x 10(9)/liter over 25.2 days. In 19 patients there was suspicion of major fungal infection; therefore they were given amphotericin B and 5-fluocytosine. Fourteen of them died; major fungal infections were documented in 5 cases. In 18% of all the deceased we found major fungal infections. There was a correlation between fungal infection, the late stages of the hematological malignancy, and the lesions on the oropharyngeal mucosa. However, in terms of the serological and culture findings no correlation appeared to exist between the group with and the group without fungal infection. The SD regime is meant to suppress the Candida cell concentration in the digestive tract but has no influence on Aspergillus in the respiratory tract.
为预防感染，我们采用了一种包含抗菌（甲氧苄啶每日480毫克、磺胺甲基嘧啶每日720毫克和多粘菌素每日0.25毫克）和抗真菌（制霉菌素每日400 - 600万国际单位）成分的SD方案。我们回顾性分析了108例患者的138个治疗周期。强化化疗导致严重粒细胞减少，粒细胞计数低于0.1×10⁹/升，持续25.2天。19例患者疑似发生严重真菌感染，因此给予他们两性霉素B和5 - 氟胞嘧啶治疗。其中14例死亡；5例确诊为严重真菌感染。在所有死亡患者中，18%被发现患有严重真菌感染。真菌感染、血液系统恶性肿瘤晚期以及口咽黏膜病变之间存在相关性。然而，从血清学和培养结果来看，真菌感染组和未感染组之间似乎没有相关性。SD方案旨在抑制消化道中的念珠菌细胞浓度，但对呼吸道中的曲霉菌没有影响。
