The Role of White Blood Cell Count in Perianal Pathologies: A Retrospective Analysis of Hematologic Malignancies

Abstract

Background and Objective: Perianal pathologies are the most common cause of perianal infections in patients with hematological malignancies. Perianal infection diagnosis in this group of patients is difficult, thus careful anorectal examination is necessary, with imaging modalities. The literature revealed a knowledge gap on the approach of anal pathologies in patients with neutropenia during diagnosis or chemotherapy. This study aimed to examine our institutional data of perianal complications and investigate the relationship among the white blood cell-neutrophil count, perianal lesion, and the type of treatment in patients with hematologic malignancies during the neutropenic period.
 Methods: Patients with a hematologic malignancy, hospitalized for cytotoxic chemotherapy, complicated by perianal pathology, and documented by at least one imaging method were included in the study.
 Results: A total of 42 patients were included in the study. The comparison between the groups revealed no statistical significance between the anal abscess formation and the neutrophil count and previous perianal pathology. A statistical significance in favor of acute myeloid leukemia was found between patient diagnosis and anal abscess development. An inverse relationship was found between the number of white blood cells at hospitalization and having an anal pathology operation. It was observed that patients with high white blood cell count were less operated on due to anal pathology.
 Conclusions: In conclusion, this article has shown that white blood cell count at the time of hospitalization in patients with hematological malignancy, can affect the operation status of patients due to anal pathologies that may occur in the neutropenic period.

Construction and validation of a risk prediction model for perianal infection in patients with haematological malignancies during chemotherapy: a prospective study in a tertiary hospital in China

“…The number of granulocytes determines the form of inflammation, the process of infection and the chance of developing sepsis. In contrast, Orhan et al argued that there is no relationship between postchemotherapy WCC, neutrophil count, duration of neutrophil deficiency and the occurrence of perianal infection 2. Although patients commonly experience bone marrow suppression after chemotherapy, they are more focused on personal protection during periods of granulocyte deficiency, and doctors often use antibiotics empirically to prevent infection, thereby reducing the incidence of infection.…”

“…In contrast, Orhan et al argued that there is no relationship between postchemotherapy WCC, neutrophil count, duration of neutrophil deficiency and the occurrence of perianal infection. 2 Although patients commonly experience bone marrow suppression after chemotherapy, they are more focused on personal protection during periods of granulocyte deficiency, and doctors often use antibiotics empirically to prevent infection, thereby reducing the incidence of infection. Our results show that the postchemotherapy WCC, neutrophil count and duration of neutrophil deficiency are not independent risk factors for perianal infection, further proving that the main factors influencing the occurrence of perianal infection during the chemotherapy period in patients with haematological malignancies are local factors in the perianal region.…”

“…Infection is an important complication in patients with haematological malignancies during chemotherapy due to a compromised immune system 1. The perianal area is a common site of infection with an incidence of 9.2%–27%, which is higher than that of other cancers 2. This is possible due to more severe bone marrow suppression and immunocompromised status in patients with haematological malignancies.…”

“… 1 The perianal area is a common site of infection with an incidence of 9.2%–27%, which is higher than that of other cancers. 2 This is possible due to more severe bone marrow suppression and immunocompromised status in patients with haematological malignancies. Perianal infection is often accompanied by severe pain, swelling and constipation, which have a serious impact on the patients’ quality of life.…”