Primary brain tumors treated with steroids and radiotherapy: low CD4 counts and risk of infection

International Journal of Radiation Oncology, Biology, Physics
Michael A HughesLawrence Kleinberg

Abstract

Patients with primary brain tumors are often treated with high doses of corticosteroids for prolonged periods to reduce intracranial swelling and alleviate symptoms such as headaches. This treatment may lead to immunosuppression, placing the patient at risk of life-threatening opportunistic infections, such as Pneumocystis carinii pneumonia. The risk of contracting some types of infection may be reduced with prophylactic antibiotics. The purpose of this study was to determine the occurrence of low CD4 counts and whether monitoring CD4 counts during and after radiotherapy (RT) is warranted. CD4 counts were measured during RT in 70 of 76 consecutive patients with newly diagnosed Grade III and IV astrocytoma and anaplastic oligodendroglioma treated with corticosteroids and seen at the Johns Hopkins Hospital. Weekly CD4 measurements were taken in the most recent 25 patients. Prophylactic trimethoprim-sulfamethoxazole (160 mg/800 mg p.o. every Monday, Wednesday, and Friday) or dapsone (100 mg p.o. daily) in those with sulfa allergy was prescribed only if patients developed a low CD4 count. Carmustine chemotherapy wafers were placed at surgery in 23% of patients, evenly distributed between the groups. No patient received any other ch...Continue Reading

References

Mar 20, 2010·Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz·Kommission für Krankenhaushygiene und Infektionsprävention beim Robert Koch-Institut (RKI)
Jul 21, 2006·Acta Neuropathologica·Caroline PietteManuel Deprez
Oct 18, 2011·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·P GavianiA Salmaggi
Sep 1, 2006·Wiener medizinische Wochenschrift·Christine Marosi
Jun 8, 2006·Nature Clinical Practice. Oncology·Vincent GanièreRoger Stupp
Apr 25, 2012·Japanese Journal of Clinical Oncology·Hiroki HayashiAkihiko Gemma
Dec 20, 2007·American Journal of Clinical Oncology·Tien PengStuart Grossman
Oct 6, 2010·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Jann N SarkariaJan C Buckner
Jul 9, 2011·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Stuart GrossmanNABTT CNS Consortium
Jul 16, 2014·Surgical Neurology International·Konstantinos GousiasMarkella Markou
Feb 17, 2009·Journal of Neuro-oncology·Julie G WalkerJohn F de Groot
Jan 9, 2016·Cancer Investigation·Miloš D MiljkovićStephanie Terezakis
Feb 26, 2013·Cancer Investigation·Jian L CampianStuart Grossman
Aug 29, 2012·Critical Reviews in Oncology/hematology·Filip Y De VosCarla M van Herpen
Feb 18, 2016·Journal of Immunology Research·Eileen S KimMichael Lim
Jul 24, 2007·Clinical Oncology : a Journal of the Royal College of Radiologists·S K T Yu, A J Chalmers
Nov 23, 2006·Hematology/oncology Clinics of North America·Tracy T Batchelor, Thomas N Byrne
Jul 6, 2015·Current Treatment Options in Oncology·Jeffrey J Raizer, Karan S Dixit
May 31, 2015·International Journal of Radiation Oncology, Biology, Physics·Jiayi HuangClifford G Robinson
Feb 1, 2015·International Journal of Radiation Oncology, Biology, Physics·Jiayi HuangShahed N Badiyan
Feb 13, 2016·International Journal of Radiation Oncology, Biology, Physics·Aaron T WildSusannah G Ellsworth
Sep 1, 2016·Neuro-oncology·Neel K GuptaJames L Rubenstein
Mar 28, 2017·Acta Clinica Belgica·Kathleen SchoovaertsLuc Heytens
Feb 28, 2008·Neurosurgery·Christopher J FarrellWilliam T Curry
Mar 8, 2017·Journal of Pediatric Hematology/oncology·Rebecca ProudfootSophie Wilne

Related Concepts

Glioblastoma Multiforme
Gliadel Wafer
Decreased Immunologic Activity [PE]
Immunologic Adjuvants
Antibiotic throat preparations
Adjuvant
Dapsone
Antifungal Antibiotics, Topical
Trimethoprim
White Blood Cell Count Procedure

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