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van Rhee KP, de Vroom SL, van Hest RM, van der Linden PD, Tonino SH, Molendijk E, Mathôt RAA, Blijlevens NMA, Knibbe CAJ, Bruggemann RJM, Geerlings SE. Impact of mucositis on oral bioavailability and systemic exposure of ciprofloxacin Gram-negative infection prophylaxis in patients with haematological malignancies. J Antimicrob Chemother 2022; 77:3069-3076. [PMID: 35996887 DOI: 10.1093/jac/dkac283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Patients with haematological malignancies frequently endure neutropenia and gastrointestinal (GI)-mucositis after high-dose chemotherapy. In these patients, ciprofloxacin is used for Gram-negative infection prophylaxis. OBJECTIVES We investigate ciprofloxacin pharmacokinetics after oral administration in patients with haematological malignancies and explore the impact of GI-mucositis on oral bioavailability and clearance in order to assure adequate systemic exposure. METHODS Adult haematological patients from two Dutch University Medical Centres received 500 mg twice daily oral ciprofloxacin for Gram-negative prophylaxis. The ciprofloxacin plasma concentrations were collected at various timepoints after oral ciprofloxacin administration and at various days after completion of chemotherapy. Data obtained after oral and intravenous ciprofloxacin administration in 28 healthy volunteers without mucositis served as a control group (391 samples). For haematological patients the degree of GI-mucositis was assessed using the Daily Gut Score (DGS), plasma citrulline and albumin. Data were analysed by non-linear mixed-effects modelling. RESULTS In total, 250 blood samples were collected in 47 patients with a wide variety of haematological malignancies between 0-30 days after start of chemotherapy. Mucositis was generally mild [DGS median (IQR) 1 (1-1) and citrulline 16 μmol/L (12-23)]. The time to Cmax was slower in haematological patients compared with healthy volunteers although no association with the degree of mucositis (defined as DGS or citrulline) could be identified. Ciprofloxacin bioavailability and clearance were 60% and 33.2 L/h, respectively. CONCLUSIONS This study supports oral dosing of ciprofloxacin as Gram-negative infection prophylaxis in haematological patients with mild-to-moderate mucositis capable of oral intake.
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Affiliation(s)
- K P van Rhee
- Department of Clinical Pharmacy Tergooi MC, Hilversum, The Netherlands.,Department of Clinical Pharmacy St Jansdal Hospital, Harderwijk, The Netherlands.,Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands
| | - S L de Vroom
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Infection and Immunity (AI&II), Amsterdam, The Netherlands
| | - R M van Hest
- Department of Hospital Pharmacy, Division of Clinical Pharmacology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - S H Tonino
- Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - E Molendijk
- Department of haematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R A A Mathôt
- Department of Hospital Pharmacy, Division of Clinical Pharmacology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - N M A Blijlevens
- Department of haematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - C A J Knibbe
- Division of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden, The Netherlands.,Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - R J M Bruggemann
- Department of Pharmacy and Radboud Institute of Health Science, Radboud University Medical Center, Nijmegen, The Netherlands.,Radboud University Medical Center, Center for Infectious Diseases, Nijmegen, The Netherlands
| | - S E Geerlings
- Department of Internal Medicine, Division of Infectious Diseases, Amsterdam Infection and Immunity (AI&II), Amsterdam, The Netherlands
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Driessen J, Kersten MJ, Visser L, den Berg A, Zijlstra JM, Tonino SH, Zwezerijnen GJ, Boellaard R, Lugtenburg PJ, Hutchings M, Nijland M, Liu RD, Morschhauser F, Brice P, Gastinne T, Jong D, Hagenbeek A, Plattel WJ, Diepstra A. LONG‐TERM FOLLOW‐UP AND BIOMARKER ANALYSES OF BRENTUXIMAB VEDOTIN AND DHAP IN RELAPSED/REFRACTORY HODGKIN LYMPHOMA PATIENTS: THE HOVON/LLPC TRANSPLANT BRAVE STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.102_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J. Driessen
- Amsterdam UMC University of Amsterdam LYMMCARE Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - M. J. Kersten
- Amsterdam UMC University of Amsterdam LYMMCARE Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - L. Visser
- University of Groningen University Medical Center Groningen Department of Pathology and Medical Biology Groningen Netherlands
| | - A. den Berg
- University of Groningen University Medical Center Groningen Department of Pathology and Medical Biology Groningen Netherlands
| | - J. M. Zijlstra
- Amsterdam UMC Vrije Universiteit Amsterdam Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - S. H. Tonino
- Amsterdam UMC University of Amsterdam LYMMCARE Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - G. J. Zwezerijnen
- Amsterdam UMC Vrije Universiteit Amsterdam Cancer Center Amsterdam Department of Radiology and Nuclear Medicine Amsterdam Netherlands
| | - R. Boellaard
- Amsterdam UMC Vrije Universiteit Amsterdam Cancer Center Amsterdam Department of Radiology and Nuclear Medicine Amsterdam Netherlands
| | - P. J. Lugtenburg
- Erasmus MC Cancer Institute University Medical Center Department of Hematology Rotterdam Netherlands
| | - M. Hutchings
- Rigshospitalet Department of Hematology Copenhagen Denmark
| | - M. Nijland
- University of Groningen University Medical Center Groningen Department of Hematology Groningen Netherlands
| | - R. D. Liu
- Amsterdam UMC University of Amsterdam LYMMCARE Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - F. Morschhauser
- Centre Hospitalier Universitaire Department of Hematology Lille France
| | - P. Brice
- Hopital Saint Louis Department of Hematology Paris France
| | - T. Gastinne
- Centre Hospitalier Universitaire Department of Hematology Nantes France
| | - D. Jong
- msterdam UMC Vrije Universiteit Amsterdam Cancer Center Amsterdam Department of Pathology Amsterdam Netherlands
| | - A. Hagenbeek
- Amsterdam UMC University of Amsterdam LYMMCARE Cancer Center Amsterdam Department of Hematology Amsterdam Netherlands
| | - W. J. Plattel
- University of Groningen University Medical Center Groningen Department of Hematology Groningen Netherlands
| | - A. Diepstra
- University of Groningen University Medical Center Groningen Department of Pathology and Medical Biology Groningen Netherlands
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Dreyling M, Ghielmini M, Rule S, Salles G, Ladetto M, Tonino SH, Herfarth K, Seymour JF, Jerkeman M. Newly diagnosed and relapsed follicular lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2021; 32:298-308. [PMID: 33249059 DOI: 10.1016/j.annonc.2020.11.008] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 12/25/2022] Open
Affiliation(s)
- M Dreyling
- Department of Medicine III, LMU Hospital Munich, Germany
| | - M Ghielmini
- Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
| | - S Rule
- Haematology, Peninsula School of Medicine, Plymouth, UK
| | - G Salles
- Service d'Hématologie, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Lyon; Université Claude Bernard Lyon-1, Pierre-Benite, France
| | - M Ladetto
- Divisione di Ematologia, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - S H Tonino
- Department of Hematology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - K Herfarth
- Department of Radiation Oncology, University of Heidelberg, Germany
| | - J F Seymour
- Department of Haematology, Peter McCallum Cancer Center & Royal Melbourne Hospital, Melbourne, University of Melbourne, Parkville, Australia
| | - M Jerkeman
- Department of Oncology, Skåne University Hospital, Lund University, Lund, Sweden
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Tonino SH, Nur E, Otten HM, Wykrzykowska JJ, Hoekstra JBL, Biemond BJ. Chest pain in sickle cell disease. Neth J Med 2013; 71:265-269. [PMID: 23799317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The differential diagnosis of chest pain in a patient with sickle cell disease is difficult and may encompass several serious conditions, including chest syndrome, pulmonary embolism and infectious complications. In this manuscript we provide an overview on the various underlying diseases that may cause chest pain in patients with sickle cell disease and provide clues for a proper diagnostic workup.
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Affiliation(s)
- S H Tonino
- Department of Haematology, Academic Medical Centre, Amsterdam, The Netherlands.
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Tonino SH, van Gelder M, Eldering E, van Oers MH, Kater AP. R-DHAP is effective in fludarabine-refractory chronic lymphocytic leukemia. Leukemia 2009; 24:652-4. [DOI: 10.1038/leu.2009.240] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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