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Neutropenic Enterocolitis: Clinical Features and Outcomes
Hamzah Abu-Sbeih1, Faisal S Ali2, Ellie Chen3
1Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Diseases of the Colon and Rectum
|December 17, 2019
Summary
Neutropenic enterocolitis, a serious complication of chemotherapy, affects 2.7% of neutropenic patients. Prompt diagnosis and management, alongside granulocyte colony-stimulating factor, are crucial for better outcomes.
Area of Science:
- Oncology
- Gastroenterology
- Infectious Diseases
Background:
- Chemotherapy patients face risks of mucosal injury and neutropenia, increasing susceptibility to neutropenic enterocolitis.
- Neutropenic enterocolitis has a poor prognosis and involves colonic mucosal invasion by bowel flora.
- This condition requires careful monitoring and management in cancer care settings.
Purpose of the Study:
- To evaluate the clinical characteristics and outcomes of neutropenic enterocolitis.
- To identify risk factors for complications and factors associated with survival in affected patients.
- To inform clinical practice regarding the diagnosis and treatment of this condition.
Main Methods:
- A retrospective cohort study was conducted at a comprehensive cancer center.
- Neutropenic enterocolitis was defined by specific criteria including absolute neutrophil count, symptoms, and imaging/biopsy findings.
- Data from 2010-2018 were analyzed, including complication and survival rates using logistic and Cox regression.
Main Results:
- Out of 49,244 neutropenic patients, 134 (2.7%) were diagnosed with neutropenic enterocolitis.
- Complications such as sepsis, perforation, pneumatosis intestinalis, and abscess formation occurred in a small percentage of patients.
- Immunosuppressive therapy use and delayed imaging were associated with increased complication risk, while older age and prolonged neutropenia were linked to lower survival.
Conclusions:
- Prompt diagnosis and management of neutropenic enterocolitis are essential to prevent severe complications.
- Granulocyte colony-stimulating factor may help shorten the duration of neutropenia, potentially improving patient outcomes.
- Further research and adherence to established management protocols are vital for improving survival rates.
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