Gastrointestinal complications in children with acute myeloid leukemia

Gray, Trevor; Ooi, Chee Y.; Tran, Dat; Traubici, Jeffrey; Gerstle, J. Ted; Sung, Lillian

doi:10.3109/10428191003695652

Cited by 21 publications

(9 citation statements)

References 72 publications

(220 reference statements)

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“…Typhlitis was most frequent in patients treated for acute leukemia 16 . During the induction phase of leukemia treatment; leukemic infiltration besides, the use of intensive chemotherapy, and the neutropenia preceding to treatment or resultant from it; one or more of these factors combining together may allow continuous bacterial invasion and colonization of the bowel wall with inflammation, ulceration, and possible necrosis and perforation 9,17 . In the present study, out of 77 patients who had episodes of intestinal complications; 47/77 (61.0%) of them were due to typhlitis, similarly to what was reported from the literature that typhlitis was the most frequent intestinal complication among patients with acute leukemias and particularly occurring in patients with AML 4,17‐20 …”

Section: Discussionsupporting

confidence: 85%

Neutropenic enterocolitis in pediatric leukemia patients treated with intensive chemotherapy in Upper Egypt

Fouad

Mohammed

Kamel

et al. 2020

Pediatric Investigation

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Importance In low resource countries, there has been scarcity of research on the risk factors associated with neutropenic enterocolitis, a serious complication that commonly develops during treatment of cancer patients. Objective To identify the pattern of intestinal complications in pediatric leukemia patients treated with intensive chemotherapy, including those with neutropenic enterocolitis; to assess the outcome; and to evaluate the risk factors associated with the mortality in these patients. Methods During the period from June 2015 to December 2016, a prospective study was carried out on pediatric patients diagnosed with acute leukemia who received induction/or re‐induction phases of chemotherapy at South Egypt Cancer Institute. Patients with documented episodes of intestinal complications were included in the study. Recovery or death from an episode of intestinal complication was utilized as the primary outcome measure for the study. Using univariable and multivariable methods, potential risk factors associated with mortality were delineated by logistic regression analysis, both for the entire intestinal complications episodes as a whole and for those episodes of neutropenic enterocolitis only. Results Out of 88 documented episodes of intestinal complications from 77 patients; 58 episodes were identified as neutropenic enterocolitis from 47 patients. In those patients who were having episodes of neutropenic enterocolitis, the presence of abdominal tenderness (OR 4.529, 95%CI 1.062–19.317, P = 0.041); a longer duration of neutropenia (OR 1.215, 95%CI 1.030–1.434, P = 0.021); and hemodynamic instability (OR 17.023, 95%CI 4.095–70.772, P < 0.001), were found to be independently associated with worse outcome. Interpretation In Upper Egypt, the use of intensive systemic chemotherapy during the induction phase of acute leukemia was found to be associated with potentially lethal intestinal complications. A high index of clinical suspicion is warranted.

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Section: Discussionsupporting

confidence: 85%

Neutropenic enterocolitis in pediatric leukemia patients treated with intensive chemotherapy in Upper Egypt

Fouad

Mohammed

Kamel

et al. 2020

Pediatric Investigation

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“…Chemotherapy induced GI complications are common in cancer patients undergoing chemotherapy (17) . Application of either fresh or old natural bee honey has been showed to be effective in managing vomiting, diarrhea, constipation, mucositis, or infectious states (18.…”

Section: Discussionmentioning

confidence: 99%

Effect of Honey Supplementation on Clostridium Difficile Infection in Childhood Cancer

Gendy

Sayed²,

Alfy³

et al. 2018

Egyptian Journal of Hospital Medicine

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Background: the treatment of cancer is associated with nausea and vomiting, oral mucositis, constipation, xerostomia and diarrhea and weight loss, additionally; chemotherapeutic agents promote inflammatory changes in the gut, intestinal necrosis, and anaerobic conditions, allowing proliferation of Clostridium Difficile. Honey, as a natural honeybee product, has antioxidant, antimicrobial, immunomodulatory and anticancer effects. Honey can fight microbial infection by its immuno-activating, anti-inflammatory and prebiotic activity. Objectives: the aim of this study was to evaluate the effect of honey supplementation on frequency of Clostridium Difficile infection (CDI) and gastrointestinal complications in pediatric patients undergoing chemotherapy. Design: a cross sectional study conducted on 40 patients with malignancy recruited from Children's Hospital, Ain Shams University, Oncology Unit and Clinic, Cairo, Egypt in the period from December 2015 to December 2016. Patients were divided into two groups; group I (25 patients) received honey in the dose of 2gm/kg 3 times dailyfor 1month) while group II (15 patients) did not receive honey. All the studied patients were subjected to medical history and clinical examination, with special emphasis on gastrointestinal complication including oral mucositis, vomiting, diarrhea, constipation, and abdominal pain. Follow up was done for weight, height z score, gastrointestinal complications and any adverse events. Stool analysis, culture, C difficle toxin A, B by ELISA was done to all patients at baseline and repeated to patients receiving honey at week 4 of supplementation. Main outcome measure frequency of CDI, gastrointestinal complication, febrile neutropenia. Results: the frequency of C difficle was 8% (2), the first case was 9 years old patient with ALL (50%) and the other 11 years old patient with Burkitts lymphoma both were diagnosed by positive stool culture and positive stool ELISA for toxin A, B. gastrointestinal complications were significantly less and improved in the supplemented group and mean of hemoglobin significant increase in group 1. Conclusion: the frequency of CDI in children with cancer 8% diagnosed by stool culture and toxin A, B study in stool. Honey improved the oral mucositis and different GIT complications associated with chemotherapy.

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“…These factors included receipt of corticosteroids for any reason within 14 days of the PI episode and receipt of any chemotherapy previously identified as being associated with gastrointestinal complications within 30 days of the PI episode. [10] Episode definition…”

Section: Methodsmentioning

confidence: 99%

Pneumatosis intestinalis in children with acute lymphoblastic leukemia and acute myeloid leukemia

Traubici

Ethier

et al. 2011

Support Care Cancer

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Gastrointestinal complications in children with acute myeloid leukemia

Cited by 21 publications

References 72 publications

Neutropenic enterocolitis in pediatric leukemia patients treated with intensive chemotherapy in Upper Egypt

Neutropenic enterocolitis in pediatric leukemia patients treated with intensive chemotherapy in Upper Egypt

Effect of Honey Supplementation on Clostridium Difficile Infection in Childhood Cancer

Pneumatosis intestinalis in children with acute lymphoblastic leukemia and acute myeloid leukemia

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