Neoadjuvant Doxorubicin and Docetaxel in Breast Cancer Patients Applied Neutropenic Enterocolitis

Aslan, Hatice Sarıkaya

doi:10.14744/etd.2019.39114

Erciyes Med J

2020

DOI: 10.14744/etd.2019.39114

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Neoadjuvant Doxorubicin and Docetaxel in Breast Cancer Patients Applied Neutropenic Enterocolitis

Hatice Sarıkaya Aslan¹

Abstract: Neutropenic enterocolitis is an acute complication of neutropenia induced by chemotherapy, characterized by inflammatory processes involving the colon and cecum that can lead to necrosis, hemorrhage, perforation, and septicemia. Usually, this condition develops after use of cytotoxic drugs, and fever and abdominal pain are the main symptoms. We present a case of a 38 year old female patient with breast cancer who received doxorubicin and docetaxel and presented typhlitis.

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Cited by 2 publications

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Docetaxel/doxorubicin

2020

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Docetaxel/doxorubicinNeutropenic enterocolitis: case report A 38-years-old woman developed neutropenic enterocolitis during treatment with doxorubicin and docetaxel. The woman was diagnosed with left breast invasive ductal carcinoma 1.5 month prior to presentation. Subsequent MRI showed a mass in the left breast and lymph nodes in the axillary region. PET/CT scan revealed axillary and mammary involvement. She started receiving neo-adjuvant chemotherapy with docetaxel 100 mg/m 2 and doxorubicin [routes not stated; not all dosages stated]. On 10 th day following chemotherapy initiation, she was admitted to emergency department for abdominal pain and bloody diarrhoea. Fever (39°C) and widespread abdominal tenderness were noted. Subsequent ultrasonography revealed cecal wall thickening. Blood test showed neutrophil 0.37 (neutropenia), WBC count 0.65, haemoglobin 12.3 and platelet count 183000 [units not stated]. She had around 10 bowel movements per day. Abdominal CT showed cecal wall thickening and no perforation was noted. She was diagnosed with neutropenic enterocolitis. She was admitted [durations of treatments to reaction onset not stated]. The woman's oral feeding was therefore stopped. She started receiving anti-biotherapy along with parenteral nutrition solution, unspecified granulocyte-colony stimulating factor (GCSF), meropenem and teicoplanin. For 5 days, she received IV potassium replacement therapy. Subsequently, neutropenia and abdominal tenderness were resolved. On the third hospital day, she started to have oral feeding. On hospital day 6, the bloody diarrhoea was resolved. GCSF therapy was discontinued following improvement in her neutrophil count to 5000. During her hospitalisation, no growth was detected in stool, urine and blood cultures. Subsequently, her condition improved completely. She received anti-biotic treatment for total 14 days. She continued to receive combination of doxorubicin and docetaxel. No complication was noted thereafter.

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Docetaxel/doxorubicin

2020

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Current Approach to Neutropenic Enterocolitis

Ertürk¹,

Turak²,

Kaynar³

et al. 2020

Erciyes Med J

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Current Approach to Neutropenic Enterocolitis Neutropenic enterocolitis (NEC) is a life-threatening clinical condition characterized by fever, abdominal pain, and thickening of the bowel wall. NEC is also known as "typhlitis" because of the involvement of the ileocecal region most often. Nonetheless, it can affect any part of the small or large intestine (1). The pathogenesis is related to reduced host defense mechanism, mucosal damage caused by cancer therapies like high-dose chemotherapy that involve alkylating agents (cyclophosphamide, ifosfamide, busulfan, melphalan, etc.) and antimetabolites (methotrexate, 5-fluorouracil, cytarabine, capecitabine,.etc.), and infiltration of the bowel walls by microorganisms (2-4). Histopathological examination typically reveals bacterial and fungal infiltration, ulcerated mucosal lesions, necrosis, edema, hemorrhage, and thickened bowel wall. Polymicrobial etiology is commonly observed, and include Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., viridans streptococci, enterococci, Bacteroides spp., and Candida spp. (1, 3).

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Neoadjuvant Doxorubicin and Docetaxel in Breast Cancer Patients Applied Neutropenic Enterocolitis

Cited by 2 publications

References 7 publications

Docetaxel/doxorubicin

Docetaxel/doxorubicin

Current Approach to Neutropenic Enterocolitis

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