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Selective antimicrobial modulation of the intestinal flora of patients with acute nonlymphocytic leukemia: a
Abstract:
Thirty-three patients with acute nonlymphocytic leukemia were studied during remission-induction treatment in a double-blind, placebo-controlled, randomized study to ascertain the effect on the incidence of infection of an oral regimen of selective antimicrobial modulation (SAM). A decrease in the number of major acquired infections was observed: three infections occurred in 16 patients receiving the SAM regimen compared with eight infections in 17 patients given the placebo. The reduction of infection was correlated with a reduction of fever, with a reduction of the frequency of administration of antimicrobial agents for the treatment of infection, and with the selective elimination of aerobic and facultative anaerobic gram-negative rods from the digestive tract. Substantial unfavorable side effects were not observed.
Insights
Selective antimicrobial modulation (SAM) reduced infections in acute nonlymphocytic leukemia patients during remission induction. This oral regimen decreased major infections, fever, and the need for antimicrobial treatments.
Area of Science:
- Oncology
- Infectious Diseases
- Microbiology
Background:
- Acute nonlymphocytic leukemia (ANLL) patients undergoing remission induction are susceptible to infections.
- Infections pose a significant risk during ANLL treatment.
- Preventive strategies are crucial to reduce infection incidence and improve patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of an oral selective antimicrobial modulation (SAM) regimen in reducing infection incidence.
- To assess the impact of SAM on fever and the need for antimicrobial agents.
- To determine the effect of SAM on the microbial composition of the digestive tract.
Main Methods:
- A double-blind, placebo-controlled, randomized study was conducted.
- Thirty-three patients with ANLL in remission induction were enrolled.
- Patients received either the SAM regimen or a placebo.
Main Results:
- Fewer major acquired infections occurred in the SAM group (3 infections in 16 patients) compared to the placebo group (8 infections in 17 patients).
- The SAM regimen was associated with reduced fever and decreased use of antimicrobial agents for infection treatment.
- SAM selectively eliminated aerobic and facultative anaerobic gram-negative rods from the digestive tract.
- No substantial unfavorable side effects were observed with the SAM regimen.
Conclusions:
- Oral selective antimicrobial modulation (SAM) is effective in reducing infection incidence in ANLL patients during remission induction.
- SAM contributes to decreased fever and reduced reliance on antimicrobial treatments.
- The observed benefits of SAM are linked to the selective eradication of specific gut bacteria.