Neutropenic enterocolitis in children and young adults with cancer: prognostic value of clinical and image findings.
Intensive chemotherapy regimens can result in severe toxicities, particularly those that involve the digestive systems, leading to morbidity and mortality in this group of patients. Acute enterocolitis can be a frequent complication. The authors performed a retrospective review or patients treated at their institution to ascertain the prognostic value of the clinical symptoms and signs of acute enterocolitis, the corresponding abdominal ultrasonographic findings, and the impact of previous chemotherapy. Amongst 1159 patients with cancer treated at the Centro Infantil Boldrini from 2003 to 2007, 188 (16.2%) patients had 1 or more episode of enterocolitis. An intestinal wall thickness of >or=3 mm on ultrasound was considered diagnostic of enterocolitis. There were 231 episodes of enterocolitis with a death rate of 11.7%. Previous therapy with cytarabine and the presence of abdominal distention affected survival. An intestinal wall thickness of >or=10 mm in the ultrasonographic examination was associated with greater mortality. In multivariate analysis, age, gender, tumor type, degree of neutropenia, intestinal wall thickness, and number of intestinal segments were not statistically significant difference. In children and young adults with cancer and enterocolitis, the clinical findings of 4 or more symptoms and presence of abdominal distention were associated with higher risk of death. Use of cytarabine and an intestinal wall thickness of >or=10 mm were associated with a higher death rate.
Rizzatti
Marcelo
M
Centro Infantil Boldrini, Campinas, Brazil. marcelo@boldrini.org.br
Brandalise
Silvia Regina
SR
de Azevedo
Amilcar Cardoso
AC
Pinheiro
Vitória Régia Pereira
VR
Aguiar
Simone dos Santos
Sdos S
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003561:Cytarabine / Q000009:adverse effects; D044504:Enterocolitis, Neutropenic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007422:Intestines / Q000000981:diagnostic imaging; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014463:Ultrasonography
D000970:Antineoplastic Agents; D003561:Cytarabine