[Neutropenic typhlitis: a frequently missed complication of aplasia-inducing tumor therapy with a possible association to the combination of etoposide with high-dose cytosine-arabinoside].
Neutropenic typhlitis (NPT) was observed in 4 of 5 adult patients with acute leukemia treated with etoposide (VP16; 100 mg/m2/d for 6 days) and high-dose cytosine-arabinoside (HD ARAC, 2 g/m2 twice daily for 6 days) in a period of 11 months. One additional patient developed NPT after combination therapy with amsacrine (mAMSA, 120 mg/m2/d for 5 days) and etoposide (80 mg/m2/d for 5 days) during the same period. These 5 cases of NPT meant a drastic rise in the incidence of NPT at our institution, where a careful retrospective review of the charts of the 128 adult patients with leukemia treated during the preceding 5 years revealed only one case of NPT. Nonsurgical treatment led to recovery in all cases. No recurrence of NPT was observed during 3 further courses of aplasia with the use of selective (2 patients) or complete (1 patient) bowel decontamination. Etoposide may potentiate the gastrointestinal toxicity of high-dose cytosine-arabinoside with a higher incidence of NPT.
Benz
G
G
Departement für Innere Medizin, Medizinische Klinik A, Universitätsspital Zürich.
Gmür
J
J
Gubler
J
J
D000208:Acute Disease; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects*; D004357:Drug Synergism; D004761:Enterocolitis, Pseudomembranous / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007938:Leukemia / Q000188:drug therapy*; D008297:Male; D009503:Neutropenia / Q000139:chemically induced; D012189:Retrospective Studies
D003561:Cytarabine; D005047:Etoposide
Die neutropenische Typhlitis: eine oft verkannte Komplikation der aplasierenden Tumortherapie mit möglicher Assoziation zur Kombination von Etoposid mit hochdosiertem Cytosin-Arabinosid.