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Neutropenic enteropathy: a 10-year review
J Baerg1, J J Murphy, R Anderson
1B.C. Children's Hospital, Vancouver, British Columbia, Canada.
Journal of Pediatric Surgery
|August 12, 1999
Summary
Neutropenic enteropathy, a complication of chemotherapy, affects children with various cancers and after bone marrow transplants. Supportive care is effective, with a 94% survival rate.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Hematology
Background:
- Neutropenic enteropathy incidence is rising due to aggressive chemotherapy regimens.
- This condition requires a comprehensive understanding of affected populations and risk factors.
Purpose of the Study:
- To identify pediatric patients affected by neutropenic enteropathy.
- To determine predisposing factors for its development.
- To evaluate the effectiveness of current treatment strategies.
Main Methods:
- A retrospective 10-year review (1988-1997) of 33 children with 38 episodes of neutropenic enteropathy.
- Patients presented with fever, abdominal pain, and neutropenia.
- Treatment included fluid resuscitation, bowel rest, antibiotics; surgery was reserved for perforation.
Main Results:
- Neutropenic enteropathy occurred in children with hematologic malignancies, solid tumors, and post-bone marrow transplant.
- Cytosine arabinoside and VP16 were common chemotherapeutic agents implicated.
- Four patients required surgery with survival; overall survival was 94%.
Conclusions:
- Neutropenic enteropathy affects a broader pediatric population than previously thought.
- Certain chemotherapeutic agents and Burkitt's lymphoma increase risk.
- Supportive care is the primary effective treatment, yielding high survival rates.