Neutropenic enterocolitis after high‐dose chemotherapy and autologous stem cell transplantation: incidence, risk factors, and outcome

Gil, Lidia; Poplawski, D.; Mól, Anna; Nowicki, Andrzej; Schneider, Agata; Komarnicki, Mieczysław

doi:10.1111/j.1399-3062.2012.00777.x

Cited by 21 publications

(36 citation statements)

References 23 publications

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“…(282) In another investigation, neutropenic colitis was more frequent in patients with non-Hodgkin lymphoma treated with BEAM. (283) Nausea, vomiting, loss of appetite, diarrhea and mucositis do not contraindicate the use of EN, but these symptoms hinder appropriate nutrition of patients undergoing HSCT, and must be evaluated and closely monitored for better adjustment of NT.…”

Section: Gastrointestinal Toxicitiesmentioning

confidence: 99%

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults

Barban¹,

Simões²,

Moraes³

et al. 2020

Einstein (São Paulo)

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The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.

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Section: Gastrointestinal Toxicitiesmentioning

confidence: 99%

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults

Barban¹,

Simões²,

Moraes³

et al. 2020

Einstein (São Paulo)

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“…A serious bleeding event was defined as one that was life-threatening or resulted in prolonged hospitalization and occurring within 30 days after HSCT [ 19 ]. Bloodstream infection was defined as the isolation of a bacterial pathogen from at least one blood culture [ 20 ]. Advanced disease was defined as acute leukaemia beyond second complete remission (CR) or disease relapse.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of thromboelastometry parameters as predictive markers for sinusoidal obstruction syndrome in patients undergoing allogeneic stem cell transplantation for acute leukaemia

et al. 2017

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Hepatic sinusoidal obstruction syndrome (previously named veno-occlusive disease, SOS/VOD) is a serious complication of allogeneic stem cell transplantation (HSCT). Early identification of patients at risk of SOS/VOD may possibly improve the outcome and reduce mortality. Rotation thromboelastometry (ROTEM) is global assay allowing for the precise assessment of both bleeding and thrombotic conditions, however, its usefulness in patients undergoing HSCT for acute leukaemia has not been studied.We evaluated the thromboelastometry parameters in patients undergoing allogeneic HSCT for acute leukaemia to identify candidate biomarkers of SOS/VOD occurrence.ROTEM assays (INTEM, EXTEM, FIBTEM, APTEM) were performed on day -10, on the day of stem cell infusion (day 0) and on days +12 and +28 post-HSCT. The diagnosis of SOS/VOD was based on the Baltimore criteria. Seven patients (26%) developed SOS/VOD. On day +12, the patients with SOS/VOD had statistically significant longer INTEM-CT (clotting time, 199 ± 33.41vs166 ± 23.65s, p = 0.0033), EXTEM-CT (69.5 ± 6.39vs.52 ± 3.42s, p = 0.0139) and FIBTEM-CT (69.5 ± 22.75vs. 50.8 ± 14.31s, p = 0.0124) compared to SOS/VOD (-). ROC curve on day +12 indicated a cut-off value of 179s in INTEM-CT (AUC = 0.91), 69s in EXTEM-CT (AUC = 0.90) and 102s in FIBTEM-CT (AUC = 0.82) for the prediction of SOS/VOD.This is the first study evaluating the usefulness of ROTEM assays in the early detection of haemostasis abnormalities predictive of SOS/VOD development in patients undergoing HSCT for acute leukemia. Patients with SOS/VOD had a significant delay in the initiation of thrombin formation in the analysed ROTEM assays. The utility of ROTEM assays in the optimal management of patients undergoing HSCT should be clarified in further prospective studies.

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“…Neutropenic enterocolitis was diagnosed in 32 (12%) of these patients. 55 In general, NE should be suspected in any neutropenic patient with fever and abdominal pain. Other symptoms include diarrhea, nausea, vomiting, abdominal distension, and lower GI bleeding.…”

Section: Neutropenic Enterocolitismentioning

confidence: 99%

“…54 The clinical manifestations typically occur within 30 days after initiation of immunosuppression. [54][55][56] The diagnosis is supported by the finding of thickening of the bowel wall on imaging. 54 The pathogenesis of NE is poorly understood, but is thought to involve a combination of factors including mucosal injury, neutropenia, and impaired host defense to intestinal organisms.…”

Section: Neutropenic Enterocolitismentioning

confidence: 99%

Pathology of Gastrointestinal and Liver Complications of Hematopoietic Stem Cell Transplantation

Mourad

Michel

Marcus

2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Despite advances in therapeutic and preventive measures, hematopoietic stem cell transplant recipients remain at risk for a variety of gastrointestinal and liver complications. Objective.— To detail the pathologic features of the various gastrointestinal and liver complications occurring after hematopoietic stem cell transplantation in relation to their clinical context. The specific complications covered include graft-versus-host disease, mycophenolate mofetil–induced injury, timeline of infections, neutropenic enterocolitis, gastrointestinal thrombotic microangiopathy, sinusoidal obstruction syndrome, hepatic iron overload, and the controversy around cord colitis syndrome. Data Sources.— The content of this article is based on pertinent peer-reviewed articles in PubMed, relevant textbooks, and on the authors' personal experiences. Conclusions.— The final histopathologic diagnosis requires the integration of clinical and histologic findings and the exclusion of other competing causes of injury. Review of the clinical data, including the original disease pretransplant, the type of transplant, the timing of the gastrointestinal and/or liver manifestations, the timing of the biopsy after transplant, the presence of graft-versus-host disease in other organs and sites, the list of drug regimens, and the clinical and laboratory evidence of infection, is the key to reaching the proper histologic diagnosis.

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Neutropenic enterocolitis after high‐dose chemotherapy and autologous stem cell transplantation: incidence, risk factors, and outcome

Cited by 21 publications

References 23 publications

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults

Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Adults

Evaluation of thromboelastometry parameters as predictive markers for sinusoidal obstruction syndrome in patients undergoing allogeneic stem cell transplantation for acute leukaemia

Pathology of Gastrointestinal and Liver Complications of Hematopoietic Stem Cell Transplantation

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