Overt gastrointestinal bleeding in haematologic neoplasms.

Area of Science:

• Hematology
• Gastroenterology
• Oncology

Background:

• Patients with acute leukemia frequently experience hemorrhages, primarily due to thrombocytopenia.
• Limited information exists on the incidence of gastrointestinal (GI) bleeding in acute leukemia.
• This study retrospectively investigated GI bleeding in patients with acute and chronic leukemias and myeloproliferative disorders (MPDs).

Purpose of the Study:

• To determine the frequency of gastrointestinal bleeding in patients with acute leukemia, chronic leukemia, and myeloproliferative disorders.
• To identify the common causes and locations of GI bleeding in these patient groups.
• To assess the mortality associated with GI bleeding in hematologic malignancies.

Main Methods:

• Retrospective analysis of 291 acute leukemia, 52 chronic leukemia, and 108 myeloproliferative disorder patients over a 6-year period.
• Documented 32 overt gastrointestinal hemorrhage episodes (25 upper, 7 lower).
• Utilized esophagogastroduodenoscopy and analyzed causes of lower GI bleeding, including neutropenic enterocolitis.

Main Results:

• Overall GI bleeding frequency was 7.1% (32/451) across hematologic malignancies.
• Acute leukemia: 5.8% bleeding; Chronic leukemia: 1.9% bleeding; MPDs: 13% bleeding (30% in blastic phase).
• Upper GI bleeding (erosive gastritis, duodenal ulcers) common in MPDs; Lower GI bleeding (neutropenic enterocolitis) prevalent in acute leukemia. 7 deaths occurred, all in acute leukemia patients.

Conclusions:

• Patients with myeloproliferative disorders are highly susceptible to gastrointestinal hemorrhage, typically manifesting as upper GI bleeding.
• Lower gastrointestinal bleeding is a significant concern in acute leukemia patients, often indicating neutropenic enterocolitis.
• Gastrointestinal bleeding can be a contributing factor to mortality, especially in acute leukemia cases.