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Upper gastrointestinal bleeding secondary to toxicity by anthracyclines, cytarabine and methotrexate in a patient

Alejandro García Martínez1, Juan Cristóbal Aguilar Martínez2, Lidia Campos Gonzaga1

  • 1UGC Enfermedades Digestivas, Hospital Universitario de Jerez de la Frontera, España.

Revista Espanola De Enfermedades Digestivas
|February 1, 2022
PubMed

A 60-year-old male patient with no medical history but acute lymphoblastic leukemia was admitted in the hematology ward for chemotherapy treatment (methotrexate, cytarabine, fludarabine and idarubicin). Approximately six days after finishing this chemotherapy, the patient began with symptoms of upper gastrointestinal bleeding (hematemesis and melena). Gastroscopy revealed erosive esophagitis, gastritis and duodenitis, as well as Forrest III ulcers in the duodenal bulb and multiple Forrest IIb ulcers in the second portion of the duodenum. Given the multiplicity of lesions, medical treatment with high doses of folinic acid, intravenous omeprazole, and transfusion of blood products was decided, with favorable evolution of the gastrointestinal bleeding. However, the patient died of respiratory infection.

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