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Janis Racevskis.

Currently, anthracycline plus cytarabine may be the usual induction therapy for patients with AML.1 The trusted intravenous combination of daunorubicin , given daily for 3 times, and cytarabine , given daily for 7 days, outcomes in complete remission in 50 to 75 percent of patients.1,2 Neither the addition of other drugs to daunorubicin and cytarabine3 nor intensification of the dose of cytarabine4-6 has been shown to improve the results.One possible description for this observation is normally that the level of contamination in the vials may have increased as time passes, with subsequent higher fungal burdens within old vials. Injectable, preservative-free glucocorticoid preparations have already been shown to be suitable media to aid or increase the growth of pathogenic fungi, including A. Fumigatus. 3,18 We also explain the increased threat of infection associated with increasing levels of methylprednisolone administered. This might reflect exposure to a growing quantity of contaminant with an increase of level of methylprednisolone administered. Furthermore, because the medication emerged in 80-mg vials, multiple injections or single shots with a dose of more than 80 mg increased the likelihood of contact with at least one contaminated vial.