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Gastrointestinal complications in children with acute myeloid leukemia
Tyler L V Gray1, Chee Y Ooi, Dat Tran
1Division of Haematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G1X8.
Insights
Gastrointestinal complications like typhlitis and enterocolitis are common in pediatric acute myeloid leukemia (AML) patients. More research is needed to understand and manage these side effects effectively.
Area of Science:
- Pediatric Oncology
- Gastroenterology
- Hematology
Background:
- Gastrointestinal (GI) complications in pediatric acute myeloid leukemia (AML) lack systematic description.
- Understanding these complications is crucial for patient care and treatment optimization.
Purpose of the Study:
- To systematically describe small and large bowel complications in children diagnosed with AML.
- To identify common and less common GI issues in this patient population.
Main Methods:
- Comprehensive literature searches were performed using Ovid Medline and EMBASE databases.
- Studies of any design describing GI complications in pediatric and adult AML patients were included.
- Data were collected from 1950 to November 2009 for Medline and 1980 to November 2009 for EMBASE.
Main Results:
- Typhlitis and enterocolitis were identified as common GI complications.
- Less frequent complications included appendicitis, pneumatosis intestinalis, and perianal infections.
- Both leukemic infiltration and chemotherapy contribute to the etiology of these GI issues.
Conclusions:
- GI complications are relatively frequent in pediatric AML.
- High-quality cohort studies are necessary to elucidate the natural history and consequences of these complications.
- Evidence-based guidelines for managing GI complications in pediatric AML require randomized trials.
Abstract:
Gastrointestinal complications in pediatric acute myeloid leukemia (AML) have not been systematically described in the literature. Our objective was to describe complications related to the small and large bowel in children with AML. Literature searches were conducted of Ovid Medline from 1950 to November 2009 and EMBASE from 1980 to November 2009. We included any study design that described gastrointestinal complications in children and/or adults with AML. Common gastrointestinal complications were typhlitis and enterocolitis. Less common complications included appendicitis, pneumatosis intestinalis, and perianal infections. Both leukemia infiltration and intensive chemotherapy likely play a role in the etiology of these conditions. There is a paucity of carefully conducted studies that describe the natural history of typhlitis and enterocolitis and evidence is needed to help guide the management of gastrointestinal complications. Gastrointestinal complications are relatively common in children with AML. Conduction of carefully performed cohort studies is needed to better understand the spectrum of symptoms and expected consequences of gastrointestinal complications. Randomized trials are required to develop evidence-based guidelines for the management of gastrointestinal complications in pediatric AML.
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