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Review
. 2023 Apr;12(2):59-65.
doi: 10.14740/jh1105. Epub 2023 Apr 30.

Neutropenic Enterocolitis: An Uncommon, but Fearsome Complication of Leukemia

Rodrick Babakhanlou  1 , Farhad Ravandi-Kashani  1 , Dimitrios P Kontoyiannis  2
Affiliations
Review

Neutropenic Enterocolitis: An Uncommon, but Fearsome Complication of Leukemia

Rodrick Babakhanlou et al. J Hematol. 2023 Apr.

Abstract

Neutropenic enterocolitis (NEC) is a life-threatening condition occurring in severely neutropenic patients, following intensive chemotherapy for leukemia. Its pathogenesis is not entirely understood and believed to be multifactorial, including mucosal injury as a result of cytotoxic drugs, profound neutropenia, impaired host defense and possibly microbiota changes. Establishing an early diagnosis is key. The management of NEC remains undefined due to lack of high-quality clinical data. With a better understanding of the disease, a more conservative approach is preferred over surgical intervention. The involvement of a multi-disciplinary team, consisting of the oncologist, infectious diseases specialists and surgeons is highly recommended. This review aims to delineate insights into the pathophysiology and clinical presentation of NEC and to emphasize the diagnostic and therapeutic approach to this condition.

Keywords: Leukemia; Neutropenia; Neutropenic enterocolitis.

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Conflict of interest statement

RB has no conflict of interest. FR receives honoraria, research funds, consulting fees from Astellas, AstraZeneca, Xenocor, Prelude, Abbvie, Novartis, Syos, Amgen, Celgene/BMS and Astex/Taiho. DPK reports honoraria and research support from Gilead Sciences and Astellas, Inc., received consultant fees from Astellas Pharma, Merck, and Gilead Sciences, and is a member of the Data Review Committee of Cidara Therapeutics, AbbVie, and the Mycoses Study Group.

Figures

Figure 1
Figure 1
CT image of a 27-year-old man with relapsed and refractory AML with neutropenic enterocolitis, presenting with right lower quadrant mass. CT: computed tomography; AML: acute myeloid leukemia.
Figure 2
Figure 2
Sign of pneumatosis intestinalis in the same patient.
See this image and copyright information in PMC

References

    1. Babakhanlou R, Ravandi-Kashani F. SOHO State of the Art Updates and Next Questions. The role of maintenance therapy in acute myeloid leukemia. Clin Lymphoma Myeloma Leuk. 2023;23(1):1–7. doi: 10.1016/j.clml.2022.11.003. - DOI - PubMed
    1. Babakhanlou R, Ravandi-Kashani F. Non-intensive acute myeloid leukemia therapies for older patients. Expert Rev Hematol. 2023;16(3):171–180. doi: 10.1080/17474086.2023.2184342. - DOI - PubMed
    1. Carobolante F, Chiaretti S, Skert C, Bassan R. Practical guidance for the management of acute lymphoblastic leukemia in the adolescent and young adult population. Ther Adv Hematol. 2020;11:2040620720903531. doi: 10.1177/2040620720903531. - DOI - PMC - PubMed
    1. Lebon D, Biard L, Buyse S, Schnell D, Lengline E, Roussel C, Gornet JM. et al. Gastrointestinal emergencies in critically ill cancer patients. J Crit Care. 2017;40:69–75. doi: 10.1016/j.jcrc.2017.03.015. - DOI - PubMed
    1. Leach C. Complications of systemic anti-cancer therapy. Medicine. 2022;50(12):805–808.

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