title: Anorectal Complications During Neutropenic Period in Patients with Hematologic Diseases.
abstract: BACKGROUND
  Neutropenic patients are susceptible to any anorectal disease, and symptomatic anorectal disease afflicts 2-32% of oncology patients. Perianal infections are the most feared complication, considering the lack of natural defense against infectious microorganisms. When septic complications develop, the anorectal disease is potentially fatal, especially in neutropenic patients in whom mortality rates range between 11-57%. Although anorectal diseases are a frequent complication with potentially fatal outcomes among patients with hematologic diseases, sufficient data are not available in the literature. In this study, we aimed to investigate the anorectal complications developing during the neutropenic period in patients with hematologic diseases.
  
  
  METHODS
  A total of 79 patients whose neutropenic period (absolute neutrophil count <500/mcL) continued for 7 days, or longer were included in the study.
  
  
  RESULTS
  A total of 34 patients out of 79 (43%) were detected to develop anorectal complications, of them 6 (7.6%) developed an anorectal infection. The patients were characterized according to the hematological disease and its status (active or not), the type of treatment and the presence of a history of an anorectal pathology before the onset of the hematologic disease. Nineteen (24.1%) patients had the history of anorectal disturbances before diagnosis of the hematologic disease, and recurrence of an anorectal pathology was found in 14 out of 19 patients(73.7%). In addition, the overall mortality rate was higher among the patients who developed anorectal complications compared to another group (41.2% vs. 22.2%, p=0.059).
  
  
  CONCLUSIONS
  Anorectal pathology is a common complication with high recurrence rate in neutropenic patients. Perianal infections are important as they can cause life-threatening outcomes although they are relatively rare among all anorectal complications. Therefore perianal signs and symptoms should be meticulously evaluated concerning early diagnosis and treatment.
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Soner
authors.initials: S
authors.lastname: Solmaz
authors.affiliation: Department of Family Medicine, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Aslı
authors.initials: A
authors.lastname: Korur
authors.affiliation: Department of Family Medicine, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Gereklioğlu
authors.affiliation: Department of Family Medicine, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Süheyl
authors.initials: S
authors.lastname: Asma
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Nurhilal
authors.initials: N
authors.lastname: Büyükkurt
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Kasar
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Yeral
authors.affiliation: Department of Hematology Research Laboratory, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: İlknur
authors.initials: İ
authors.lastname: Kozanoğlu
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Boğa
authors.affiliation: Department of Hematology, Adana Hospital of Başkent University, Adana, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ozdoğu