Mayo Clin Proc:接受细胞毒性化疗的癌症患者:FMT治疗复发性CDI效果如何?

2017-12-26 吴星 环球医学

2017年11月,发表于《Mayo Clin Proc》的单机构回顾性病例系列,考察了细胞毒性化疗治疗的癌症患者中,粪便菌群移植(FMT)治疗复发性艰难梭菌感染(CDI)的有效性和疗效。

2017年11月,发表于《Mayo Clin Proc》的单机构回顾性病例系列,考察了细胞毒性化疗治疗的癌症患者中,粪便菌群移植(FMT)治疗复发性艰难梭菌感染(CDI)的有效性和疗效。

目的:在一项单机构回顾性病例系列中,旨在研究细胞毒性化疗治疗的癌症患者中,FMT治疗 CDI的有效性和安全性。

患者和方法:2012年8月1日~2016年6月30日,23例潜在血液学(13例)或实体恶性肿瘤(10例)的连续患者。对这些患者进行了FMT治疗复发性CDI。

结果:所有患者在FMT前都接受了中位12个月的细胞毒性化疗(范围,1~340个月)。在FMT前,患者出现了中位4次(范围,2~9)CDI发作,并接受了中位106天(42~495天)的万古霉素、甲硝唑或非达霉素治疗。12例患者(52%)在某一阶段具有严重/严重复杂的CDI。8例患者(35%)患有活跃性癌症,5例(22%)在12周的FMT内接受了化疗。除了3例患者(13%),其他所有患者的腹泻都在60天的FMT内缓解而不复发(所有都具有阴性CDI结果)。FMT后存活60天或更长时间的22例患者中,11例(48%)进行了进一步的化疗,10例(43%)接受了更多的抗生素。2例患者(9%)在FMT后的14和22个月CDI复发。1例患者FMT后的5天死亡,死因为心脏骤停,与FMT无关。没有与FMT直接相关的其他严重不良事件和感染并发症发生。

结论:该系列证实,在接受细胞毒性化疗治疗的患者中,对多种复发性CDI而言,FMT是一种高度有效和安全的治疗方法。

原始出处:

Hefazi M, Patnaik MM, Hogan WJ, et al. Safety and Efficacy of Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection in Patients With Cancer Treated With Cytotoxic Chemotherapy: A Single-Institution Retrospective Case Series.Mayo Clin Proc. 2017 Nov;92(11):1617-1624. doi: 10.1016/j.mayocp.2017.08.016. Epub 2017 Nov 1.

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    2018-03-08 linlin2312
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    2017-12-28 yb6560
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1976937, encodeId=bcae19e693775, content=<a href='/topic/show?id=b9f11560065' target=_blank style='color:#2F92EE;'>#ROC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15600, encryptionId=b9f11560065, topicName=ROC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Mar 08 05:14:00 CST 2018, time=2018-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909685, encodeId=96901909685f8, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Mar 15 16:14:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280367, encodeId=0cd2128036ee1, content=<a href='/topic/show?id=a90ce550e8' target=_blank style='color:#2F92EE;'>#FMT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7550, encryptionId=a90ce550e8, topicName=FMT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289576, encodeId=5f7112895e6a4, content=<a href='/topic/show?id=cbb8e1356f7' target=_blank style='color:#2F92EE;'>#癌症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71356, encryptionId=cbb8e1356f7, topicName=癌症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=10ba218, createdName=zgwhgch, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509628, encodeId=c1fd15096284f, content=<a href='/topic/show?id=cef6439e64' target=_blank style='color:#2F92EE;'>#CDI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4397, encryptionId=cef6439e64, topicName=CDI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b08f10104041, createdName=ylz8406, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529516, encodeId=07321529516ae, content=<a href='/topic/show?id=a02ce793707' target=_blank style='color:#2F92EE;'>#细胞毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77937, encryptionId=a02ce793707, topicName=细胞毒性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10b211951227, createdName=appleandpeer, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601954, encodeId=96e01601954d4, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=)]
    2017-12-28 ylz8406
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  7. [GetPortalCommentsPageByObjectIdResponse(id=1976937, encodeId=bcae19e693775, content=<a href='/topic/show?id=b9f11560065' target=_blank style='color:#2F92EE;'>#ROC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15600, encryptionId=b9f11560065, topicName=ROC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d590125, createdName=linlin2312, createdTime=Thu Mar 08 05:14:00 CST 2018, time=2018-03-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1909685, encodeId=96901909685f8, content=<a href='/topic/show?id=8f1f42518d8' target=_blank style='color:#2F92EE;'>#复发性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42518, encryptionId=8f1f42518d8, topicName=复发性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Mar 15 16:14:00 CST 2018, time=2018-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1280367, encodeId=0cd2128036ee1, content=<a href='/topic/show?id=a90ce550e8' target=_blank style='color:#2F92EE;'>#FMT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7550, encryptionId=a90ce550e8, topicName=FMT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4b65161, createdName=yb6560, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1289576, encodeId=5f7112895e6a4, content=<a href='/topic/show?id=cbb8e1356f7' target=_blank style='color:#2F92EE;'>#癌症患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71356, encryptionId=cbb8e1356f7, topicName=癌症患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=10ba218, createdName=zgwhgch, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1509628, encodeId=c1fd15096284f, content=<a href='/topic/show?id=cef6439e64' target=_blank style='color:#2F92EE;'>#CDI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4397, encryptionId=cef6439e64, topicName=CDI)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b08f10104041, createdName=ylz8406, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1529516, encodeId=07321529516ae, content=<a href='/topic/show?id=a02ce793707' target=_blank style='color:#2F92EE;'>#细胞毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77937, encryptionId=a02ce793707, topicName=细胞毒性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=10b211951227, createdName=appleandpeer, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1601954, encodeId=96e01601954d4, content=<a href='/topic/show?id=2f801469e57' target=_blank style='color:#2F92EE;'>#PRO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14697, encryptionId=2f801469e57, topicName=PRO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=55683, createdName=仁医06, createdTime=Thu Dec 28 07:14:00 CST 2017, time=2017-12-28, status=1, ipAttribution=)]
    2017-12-28 仁医06