Abstract
An increased incidence of severe infections, in particular gastrointestinal complications, was observed in our institution among 35 consecutive patients with acute myelogenous leukemia submitted to their first intensive pilot protocol for induction of remission containing idarubicin, etoposide and cytosine arabinoside. Ten patients presented fever and severe diarrhea (4 or more loose stools/day for at least 4 consecutive days); 3 of these developed ileothyphlitis, which proved fatal in 2 cases, 7 needed amphotericin B addition to antibacterial treatment and, in 6 cases, a fungal infection was documented. We have compared these 10 patients with the other 25 submitted to the same chemotherapeutic protocol and the incidence of candidemias (5/10 compared to 0/25), the early use of systemic fluconazole from the onset of fever (0/10 compared to 9/25) and the pre-emptive use of total parenteral nutrition (0/10 compared to 8/25) differed in the two groups. We conclude that during this chemotherapeutic protocol the incidence of severe gastrointestinal infectious complications was particularly high (28.5%) and, even though only a small number of patients were studied, our results suggest an important role forCandida spp. in the pathogenesis of this disease.
Similar content being viewed by others
References
Brook A, Glass NR, Sollinger H (1985) Neutropenic enterocolitis in adults. Review of the literature and assessment of surgical intervention. Am J Surg 149:405–408
Hunter TB, Bjelland JC (1984) Gastrointestinal complications of leukemia and its treatment. AJR Am J Roentgenol 142:513–518
Mower WJ, Hawkins JA, Nelson EW (1986) Neutropenic enterocolitis in adults with acute leukemia. Arch Surg 121:571–574
Slavin RE, Dias MA, Saral R (1978) Cytosine arabinoside induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols. Cancer 42:1747–1759
Sloas MM, Flynn PM, Kaste SC, Patrick CC (1993) Typhlitis in children with cancer: a 30-year experience. Clin Infect Dis 17:484–490
Varki AP, Armitage JO, Feagler JR (1979) Typhlitis in acute leukemia. Cancer 43:695–697
Vlasveld LT, Zwaan FE, We, et al (1991) Neutropenic enterocolitis following treatment with cytosine arabinoside-containing regimens for hematological malignancies - a potential role of amsacrine. Ann Hematol 62:129–134
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Micozzi, A., Cartoni, C., Monaco, M. et al. High incidence of infectious gastrointestinal complications observed in patients with acute myeloid leukemia receiving intensive chemotherapy for first induction of remission. Support Care Cancer 4, 294–297 (1996). https://doi.org/10.1007/BF01358883
Issue Date:
DOI: https://doi.org/10.1007/BF01358883