Typhlitis complicating induction therapy in adult acute myeloid leukemia.
In a retrospective analysis of 161 consecutive adult patients with de novo acute myeloid leukemia undergoing induction therapy, including cytarabine, etoposide and anthracyclines, seven patients (4.3%) developed typhlitis. All presented severe neutropenia, fever, abdominal pain and tenderness within 16 days from starting chemotherapy (median 11 days; range 5-16). Three patients underwent surgery and survived, four were treated only with supportive therapy: two recovered and two died. In our experience early recognition of typhlitis and rapid recovery of the neutrophils are the most important determinants of the results of surgical and/or medical approaches. The management of typhlitis, a life-threatening condition, is controversial and depends on many factors characterizing each patient, which must be evaluated in collaboration between the surgeon and the hematologist.
Pastore
D
D
Department of Medicine-DIMIMP Hematology, University of Bari, Italy.
Specchia
G
G
Mele
G
G
Montagna
M T
MT
Margari
A
A
Carluccio
P
P
Nacchiero
M
M
Liso
V
V
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002429:Cecal Diseases / Q000209:etiology* / Q000628:therapy; D004760:Enterocolitis / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011379:Prognosis; D012189:Retrospective Studies
D000970:Antineoplastic Agents