Gastrointestinal disease in patients receiving salvage chemotherapy or bone marrow transplantation.
Thirty-three patients receiving either salvage chemotherapy or bone marrow transplantation with potential surgical illness related to gastrointestinal symptoms were identified. Sixty-nine percent of patients received salvage chemotherapy for either hematological (61%) or visceral malignancies (39%). Twenty-one percent of patients had a previous bone marrow transplant. Twenty-two (66%) had an absolute neutrophil count less than 10(3)/mm3. Ulcerative foregut disease (51%) and perianal disease (21%) were the most common disease entities identified. Esophagogastroduodenoscopy (79%) and anorectal examination under anesthesia (21%) provided the greatest diagnostic yield. The mean hospitalization was 21 days. Surgery was performed in 21% of patients, but was seldom required for abdominal pain or intestinal bleeding. Perianal disease was often chronic and required multiple operative procedures. Overall, a 27% mortality was found. Gastrointestinal disease in patients receiving salvage chemotherapy or bone marrow transplantation is usually manifested by bleeding and localized to the proximal gut, or related to perianal disease.
Handler
B S
BS
Department of Surgery, St. Louis University School of Medicine, MO 63110-0250.
Longo
W E
WE
Vernava
A M
AM
Herrmann
V M
VM
Dunphy
F R
FR
D000970:Antineoplastic Agents / Q000009:adverse effects*; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D016879:Salvage Therapy / Q000009:adverse effects*
D000970:Antineoplastic Agents