Neutropenic Enterocolitis in Patients With Acute Leukemia: Prognostic Significance of Bowel Wall Thickening Detected by Ultrasonography

Cartoni, Claudio; Dragoni, Francesco; Micozzi, Alessandra; Pescarmona, Edoardo; Mecarocci, Sergio; Chirletti, Piero; Petti, Maria Concetta; Meloni, Giovanna; Mandelli, F

doi:10.1200/jco.2001.19.3.756

Cited by 172 publications

(111 citation statements)

References 19 publications

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“…The need for radiological confirmation is discussed but recommended by many authors [61]. Patients with mural thickening detected sonographically or by computerized tomography scan have a poorer prognosis than patients without this finding [63].…”

Section: Gastrointestinal Infectionsmentioning

confidence: 99%

Risk of Infections in Adult Patients with Haematological Malignancies

Nørgaard¹

2012

TOIDJ

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Abstract:Patients with haematological malignancies are at increased risk of infections not only because of the malignancy itself but also because of neutropenia induced by intensive chemotherapeutic treatment, and the cytotoxic effect on the cells that line the alimentary tract. In haematological malignancy patients with a compromised inflammatory response, the classic signs and symptoms of infection may be masked. The results of blood cultures therefore play an important diagnostic role. Bacteraemia is a relatively common serious complication occurring in around 15% of patients with haematological malignancies within the first years after diagnosis but the risk varies between different types of haematological malignancies. Other risk factors for bacteraemia are presence of mucositis, neutropenia, and use of central venous catheters. Invasive fungal diseases are also serious infectious complications in this population. Viral infections are particularty often in patients that have received a bone marrow transplant. Future work in this field could focus on potential modifiable risk factors and on how time since haematological diagnosis may influence risk of infection.

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Section: Gastrointestinal Infectionsmentioning

confidence: 99%

Risk of Infections in Adult Patients with Haematological Malignancies

Nørgaard¹

2012

TOIDJ

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“…Also, inflammation in the adjoint mesenteric fat tissue is frequently observed. If the patient is unable to be taken to abdominal CT, bedside USG is a very good screening method [10]. Abdominal CT is very important in evaluating the response to therapy, as well as being helpful in detecting complications and surgery requiring complications such as pneumotosis intestinalis, pneumoperitonium, acid and abscess [9].…”

Section: Discussionmentioning

confidence: 99%

“…As a CT finding, there is a direct relationship between intestine wall thickness and mortality. An intestine wall thickness equal to or above 10 mm's in USG is a bad prognosis indicator [10]. It can imitate diseases like appendicitis, colonical pseudo-obstruction, inflammatory intestine disease and diverticulitis [5].…”

Section: Discussionmentioning

confidence: 99%

“Typhlitis” A Rare Diagnose For Emergency Room; Case Report

Güllüpınar¹

2015

Ann Clin Anal Med

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ÖzetTiflitis, çıkan kolon ve çekumun nekroz ve perforasyonu ile karakterize akut bir tablodur. Sıklıkla lösemi ve lenfoma ile ilişkili görülür. Maligniteli bir hastada, nötrope-ni, ateş, sağ alt kadranda ağrı ve hassasiyet mevcutsa ilk akla gelmesi gereken tiflitisdir. Tiflitis tanısında batın bilgisayarlı tomografisi kullanılır. Tiflitis yüksek dü-zeyde mortalite ve morbiditeyle ilişkilidir. Tiflitisin tedavisi medikal veya komplikasyonlara göre cerrahi tedavidir. Erken tanı konulmalı ve tedaviye başlanılmalı-dır. Yazımızda, acil servislerde nadir görülen bir onkolojik acil olan "Tiflitis" olgusunu sunup, tanı ve tedavi yöntemlerini literatür bilgileri eşliğinde gözden geçirdik. Anahtar KelimelerNötropeni; Karın Ağrısı; Ateş; Enterokolit; Malignite AbstractTyphlitis is an acute table that is characterised by the necrosis and perforation of the ascendant colon and cecum. It is often observed to be related to leukemia and lymphoma. If neutropenia, fever, pain in lower right quadrant and sensibility is present in a patient with malignancy, the first thing to think about is typhlitis. Abdominal computed tomography is used in the diagnosis of typhlitis.Typhlitis is related to high mortality and morbidity.The theraphy for typhlitis is medical or, depending on the complications, surgical. Diagnosis should be early and therapy should be started immediately. In our paper, we have presented the "typhlitis" case, which is an oncological emergency that is rarely observed in emergency services, and examined the diagnosis and therapy methods in the light of the relevant literature.

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“…5 Increased bowel wall thickness by ultrasound or computed tomography scan has been recently suggested as an additional diagnostic criterion. 5,[32][33][34] However, monitoring bowel wall thickness has not been validated, and routine application of radiological imaging in all patients undergoing chemotherapy is expensive. Furthermore, increased bowel wall thickness can be observed in other conditions that affect cancer patients, including graft versus host disease and infections.…”

Section: Discussionmentioning

confidence: 99%

“…43 Because none of our patients required surgical intervention, we recommend supportive care as the mainstay of management while reserving surgical evaluation to patients with bowel perforation or uncontrolled gastrointestinal bleeding. 5,32,[44][45][46] Because there is no uniform definition and grading for neutropenia-related lower alimentary tract mucositis, and because the Common Terminology Criteria for Adverse Events toxicity grading is clinician-based and remains the principal clinical and research system for reporting adverse events in oncology clinical trials, 47 we recommend the application of the Common Terminology Criteria for Adverse Events grading for enteritis and/or colitis in future reports of lower alimentary tract mucositis. 10 We conclude that lower alimentary tract mucositis is not an uncommon event after sequential courses of chemotherapy including ASCT but does not appear to contribute to mortality.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors for lower alimentary tract mucositis after 1529 courses of chemotherapy in a homogenous population of oncology patients

Krishna¹,

Zhao²,

Grazziutti³

et al. 2010

Cancer

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BACKGROUND:Lower alimentary tract mucositis is a serious complication of chemotherapy. The aim of the study was to determine the incidence, risk factors, and mortality of lower alimentary tract mucositis in a homogeneous population of patients with newly diagnosed myeloma receiving similar antineoplastic therapy and standardized supportive care. METHODS: Lower alimentary tract mucositis was evaluated among 303 consecutive patients with myeloma (2004)(2005)(2006)(2007) enrolled in a clinical trial consisting of induction chemotherapy, tandem melphalan-based autologous stem cell transplantation (ASCT), and consolidation. Lower alimentary tract mucositis was defined as neutropenia-associated grade II-IV enteritis/colitis. Pretreatment risk factors were examined including body surface area (BSA), serum albumin (albumin), and estimated creatinine clearance (CrCl). Multiple logistic regression model was used to compute adjusted odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Forty-seven (15.5%) patients developed lower alimentary tract mucositis during 1529 courses of chemotherapy (including 536 melphalan-based ASCT). Pre-enrollment BSA <2 m 2 (OR, 2.768; 95% CI, 1.200-6.381; P ¼ .0169) increased the risk for lower alimentary

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Neutropenic Enterocolitis in Patients With Acute Leukemia: Prognostic Significance of Bowel Wall Thickening Detected by Ultrasonography

Abstract: Symptomatic patients with sonographically detected bowel wall thickening have a poor prognosis compared with patients without this finding. In addition, mural thickness of more than 10 mm is associated with poorer outcome among patients with NE.

Cited by 172 publications

References 19 publications

Risk of Infections in Adult Patients with Haematological Malignancies

Risk of Infections in Adult Patients with Haematological Malignancies

“Typhlitis” A Rare Diagnose For Emergency Room; Case Report

Incidence and risk factors for lower alimentary tract mucositis after 1529 courses of chemotherapy in a homogenous population of oncology patients

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