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Review
. 2024 Apr;13(1-2):1-11.
doi: 10.14740/jh1251. Epub 2024 Apr 9.

Anorectal Infections in Neutropenic Leukemia Patients: A Common Clinical Challenge

Rodrick Babakhanlou  1 , Farhad Ravandi-Kashani  1 , Angel G Hita  2 , Dimitrios P Kontoyiannis  3
Affiliations
Review

Anorectal Infections in Neutropenic Leukemia Patients: A Common Clinical Challenge

Rodrick Babakhanlou et al. J Hematol. 2024 Apr.

Abstract

Anorectal infections in neutropenic leukemia patients are a significant and potentially life-threatening complication. The pathogenesis of this condition is not entirely understood and believed to be multifactorial, including mucosal injury as a result of cytotoxic drugs, profound neutropenia and impaired host defense. Establishing an early diagnosis is key and often made clinically on the basis of signs and symptoms, but also from imaging studies demonstrating perianal inflammation or fluid collection. The management of anorectal infections in neutropenic leukemia patients is not straightforward, as there are no well-conducted studies on this entity. This review seeks to provide a framework into the pathophysiology and clinical presentation of anorectal infections in neutropenic leukemia patients, propose a diagnostic approach and to discuss controversies in the management of this condition.

Keywords: Acute leukemia; Anal abscess; Anorectal sepsis; Leukemia; Perianal sepsis; Rectal abscess.

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Conflict of interest statement

RB has no conflict of interest. AGH 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
Location of anorectal abscesses.
Figure 2
Figure 2
The approach to perirectal abscesses in neutropenic leukemia patients.
See this image and copyright information in PMC

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