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Clinical Features and Recurrence Pattern of Perianal Abscess in Patients with Acute Myeloid Leukemia
Hung Chang1, Ming-Chung Kuo, Tzung-Chih Tang
1Division of Hematology-Oncology, Chang Gung Memorial Hospital, Kweishan, Taiwan.
Introduction:
Perianal abscess may develop during neutropenia periods in patients with acute myeloid leukemia (AML). The standard of care for perianal abscess in AML is unclear.
Methods:
We retrospectively collected patient data in our institute from 2009 to 2012.
Results:
Two hundred ninety-two patients with AML were analyzed. In total, 1,051 chemotherapy sessions were administered. Twenty-three patients experienced perianal abscess. Patients with perianal abscess were younger than those without (44 vs. 60 years, p < 0.0001). Perianal abscess developed in various phases of treatment and in the stem cell transplantation period. Twelve recurrences developed in 6 patients. Patients with a prior perianal abscess have a 10-fold risk of developing a subsequent abscess following further chemotherapy. The microbiology profile revealed that most pathogens were derived from the intestinal tracts, which was similar to the findings of previous studies. The 28-day mortality was 14.3% and the direct cause of death was not perianal abscess in any case. Surgical interventions had no impact on recurrence or survival.
Conclusion:
In patients with AML, perianal abscess results from gastrointestinal tract pathogens. Many patients do not require surgical interventions. The mortality is low but recurrence is common following subsequent chemotherapies. Therefore, awareness of recurrence is important for the timely management of perianal abscess in AML.
Insights
Perianal abscesses in acute myeloid leukemia (AML) patients often stem from intestinal pathogens. While mortality is low, recurrence is common after further chemotherapy, necessitating vigilant management.
Area of Science:
- Hematology
- Oncology
- Surgical Infections
Background:
- Perianal abscesses can occur during neutropenia in acute myeloid leukemia (AML) patients.
- The optimal management strategy for perianal abscess in AML remains undefined.
Purpose of the Study:
- To investigate the characteristics, outcomes, and recurrence patterns of perianal abscess in patients with AML.
Main Methods:
- A retrospective analysis of 292 AML patients treated between 2009 and 2012.
- Evaluation of 1,051 chemotherapy sessions and associated perianal abscess development.
Main Results:
- Twenty-three patients developed perianal abscess, often younger than their counterparts without abscesses.
- Recurrence was observed in 6 patients (12 episodes), with a tenfold increased risk for those with prior abscesses.
- Intestinal tract pathogens were the primary cause; surgery did not influence recurrence or survival.
Conclusions:
- Perianal abscess in AML is linked to gastrointestinal pathogens, frequently not requiring surgery.
- High recurrence rates after chemotherapy highlight the need for awareness and timely management.
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