Malignant disease leukemias

Patients with active malignant disease may receive killed vaccines or toxoids but should not be given live vaccines. Live virus vaccines may be administered to persons with leukemia who have not received chemotherapy for at least 3 months. 

Malignant diseases Corticoids are used in combination with other therapy in the treatment of Hodgkin s disease, acute lymphatic leukemia and other lymphomas. 

Leukemia, a malignant disease of the blood-forming organs, may cause optic nerve dysfunction manifested as papilledema with or without optic nerve infiltration. These patients present with a variable clinical pictiu e that may include white elevated lesions of the optic nerve from leitkemic cell infiltration but with preservation of vision. 

The concentration of acid mucopolysaccharides in serum, and their excretion in urine, are increased in patients with rheumatoid arthritis (D7), lupus erythematosus (D6), diabetes (C7), and leukemia (R2, SIO) and other malignant diseases (R2). The daily urinary excretion of acid mucopolysaccharides was within the normal range in cases of acute hepatitis, but was usually increased in chronic hepatitis and in florid cirrhosis (K5). A decrease in the amount of acid mucopolysaccharides excreted was found in primary hepatoma, whereas in most cases of obstructive jaundice the amount was markedly increased (K5). 

Malignant diseases hairy cell leukemia, chronic myelogenous leukemia, cutaneous T cell lymphoma, follicular lymphoma, multiple myeloma, Kaposi s sarcoma, diffuse melanoma, renal cell carcinoma, carcinoid tumors Viral diseases condylomata acuminata, chronic active hepatitis B and C... 

There are no known contraindications to the use of IPV. OPV should not be given to persons who are immunocompromised due to immunodeficiency diseases, leukemia, lymphoma or generalized malignancy or who are immunosuppressed due to therapy with glucocorticoids, alkylating drugs, antimetabolites, or radiation. If poliomyelitis immunization is indicated in such persons, IPV should be used. OPV should also be avoided when immunizing household contacts of immunocompromised patients. 

Monocytosis (>800/mm of blood) occurs with some infections (e.g., tuberculosis, histoplasmosis, toxoplasmosis, bacterial endocarditis, and salmonellosis), collagen vascular diseases (rheumatoid arthritis and systematic lupus erythematosus), gastrointestinal disorders (ulcerative cohtis and alcoholic liver disease), leukemias, and up to 60% of nonhematologic malignancies, whereas abnormally low monocyte concentrations occur in patients with hairy cell leukemia or aplastic anemia." ... 

Patients with active malignant disease may receive killed vaccines or toxoids but should not be given live vaccines. The MMR vaccine is not contraindicated for close contacts, however. Live virus vaccines may be administered to persons with leukemia who have not received chemotherapy for at least 3 months. Vaccines should be timed to avoid coinciding with the start of chemotherapy or radiation therapy. Annual influenza vaccine should be administered... 

An increase of extrahepatic accumulation of nanocolloid in the bone marrow is seen with hyperplastic bone marrow and with certain hematological disorders (polycytemia, leukemia) (Hofer et al. 1964). In patients with malignant disease, bone marrow scintigraphy may offer early detection of bone marrow infiltration (Hotze et al. 1984 Munz 1984b). 

Similarly, intrathecal administration of methotrexate in the treatment and prevention of meningeal leukemia, intravesical treatment of superficial bladder cancer, and direct administration of drugs into blood vessels feeding a localized cancer, have been evaluated for more than a decade as therapeutic strategies in the management of malignant disease. 

Those at risk of developing tuberculosis (eg, those with Hodgkin s disease, severe diabetes mellitus, leukemia, and other serious illnesses and those receiving corticosteroids or drug therapy for a malignancy)... 

O The acute leukemias are diseases of bone marrow resulting from aberrant proliferation of hematopoietic precursors. The hallmark of these malignancies is the leukemic blast cell, a visibly immature and abnormal cell in the peripheral blood that often replaces the bone marrow and interferes with normal hematopoiesis. These blast cells proliferate in the marrow and inhibit normal cellular elements, resulting in anemia, neutropenia, and thrombocytopenia. Leukemia also may infiltrate other organs, including the liver, spleen, bone, skin, lymph nodes, and central nervous system (CNS). Virtually anywhere there is blood flow, the potential for extramedullary (outside the bone marrow) leukemia exists. 

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