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Neutropenic enterocolitis in acute myeloid leukemia
N Colovic1, Z Rajic, M Sretenovic
1Institute of hematology , Clinical Ceneter of Serbia, Belgrade.
Acta Chirurgica Iugoslavica
|March 18, 2005
Summary
Gastrointestinal complications like neutropenic enterocolitis are critical during acute myeloid leukemia chemotherapy. Early diagnosis and multidisciplinary care, including imaging, improve patient outcomes.
Area of Science:
- Hematology
- Gastroenterology
- Oncology
Background:
- Acute myeloid leukemia (AML) treatment with chemotherapy can lead to severe gastrointestinal (GI) complications.
- Leukemic infiltration and chemotherapy-induced immunosuppression increase risks of mucosal ulcers, bleeding, perforation, and infections like neutropenic enterocolitis.
Observation:
- A 37-year-old male with AML (M5 subtype) developed fever, abdominal pain, and diarrhea during chemotherapy.
- Clinical deterioration, despite broad-spectrum antibiotics, prompted ultrasonography revealing bowel wall thickening.
- The patient experienced neutropenia and thrombocytopenia, managed with transfusions and granulocyte colony-stimulating factor (G-CSF).
Findings:
- Neutropenic enterocolitis was suspected and treated with intensified antibiotics and antifungals.
- Fever and GI symptoms improved after G-CSF administration and central venous catheter removal.
- Successful management highlights the importance of prompt diagnosis and intervention for GI complications in AML patients.
Implications:
- Accurate and timely diagnosis of GI complications is crucial for managing acute myeloid leukemia patients undergoing chemotherapy.
- Multidisciplinary collaboration between hematologists and surgeons is vital for optimal patient care.
- Abdominal ultrasonography is a valuable tool for diagnosing neutropenic enterocolitis and guiding treatment decisions.