Document Detail


Neutropenic enterocolitis in patients with acute leukemia: prognostic significance of bowel wall thickening detected by ultrasonography.
MedLine Citation:
PMID:  11157028     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Neutropenic enterocolitis (NE) is a severe complication of intensive chemotherapy and is barely identifiable by clinical signs alone. Ultrasonography (US) supports the diagnosis of NE by showing pathologic thickening of the bowel wall. The aim of this study was to evaluate the prognostic value of the degree of mural thickening evaluated by US in patients with clinically suspected NE. PATIENTS AND METHODS: Neutropenic patients with fever, diarrhea, and abdominal pain after intensive chemotherapy for hematologic malignancies were studied with abdominal US. We evaluated the degree of bowel wall thickening detected by US and its correlation with the duration of the clinical syndrome as well as NE-related mortality. RESULTS: Eighty-eight (6%) of 1,450 consecutive patients treated for leukemia had clinical signs of NE. In 44 (50%) of 88 patients, US revealed pathologic wall thickening (mean +/- SD, 10.2 +/- 2.9 mm; range, 6 to 18). The mean duration of symptoms was significantly longer in this group (7.9 days) than among patients without mural thickening (3.8 days, P <.0001), and the NE-related mortality rate was higher (29.5% v 0%, P <.001). Patients with bowel wall thickness of more than 10 mm had a significantly higher mortality rate (60%) than did those with bowel wall thickness < or = 10 mm (4.2%, P <.001). CONCLUSION: 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.
Authors:
C Cartoni; F Dragoni; A Micozzi; E Pescarmona; S Mecarocci; P Chirletti; M C Petti; G Meloni; F Mandelli
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical oncology : official journal of the American Society of Clinical Oncology     Volume:  19     ISSN:  0732-183X     ISO Abbreviation:  J. Clin. Oncol.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309333     Medline TA:  J Clin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  756-61     Citation Subset:  IM    
Affiliation:
Department of Biotecnologie Cellulari ed Ematologia, Policlinico Umberto I, University La Sapienza, Rome, Italy. cartoni@bce.med.uniroma1.it
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adolescent
Adult
Blast Crisis / complications,  drug therapy
Child
Enterocolitis / chemically induced,  mortality,  pathology,  ultrasonography*
Humans
Intestines / pathology,  ultrasonography*
Leukemia, Myelogenous, Chronic, BCR-ABL Positive / complications,  drug therapy,  pathology
Leukemia, Myeloid / complications*,  drug therapy
Lymphoma, Non-Hodgkin / complications,  drug therapy
Middle Aged
Neutropenia / chemically induced,  mortality,  pathology,  ultrasonography*
Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications*,  drug therapy
Prognosis

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