Enterocolitis neutropénica: Características clínicasyresultados

Translated title of the contribution: Neutropenic enterocolitis: Clinical features and outcomes

Hamzah Abu-Sbeih, Faisal S. Ali, Ellie Chen, Niharika Mallepally, Wenyi Luo, Yang Lu, Wai Chin Foo, Wei Qiao, Pablo C. Okhuysen, Javier A. Adachi, Ray Y. Hachem, Mehmet Altan, Robert R. Jenq, Yinghong Wang

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

BACKGROUND: Patients undergoing chemotherapy are at risk for mucosal injury and neutropenia, which facilitate colonic mucosal invasion by the bowel flora and subsequent neutropenic enterocolitis, which has a poor prognosis. OBJECTIVE: This study aimed to assess the clinical features and outcomes of neutropenic enterocolitis in patients at a comprehensive cancer center. DESIGN: This is a retrospective cohort study. SETTING: The study was conducted at the University of Texas MD Anderson Cancer Center. PATIENTS: Neutropenic enterocolitis was defined by the presence of an absolute neutrophil count <1000/mm3, compatible abdominal symptoms, and either mucosal thickening on abdominal imaging or mucosal injury on colon biopsy. Patients who had been diagnosed between 2010 and 2018 were included. MAIN OUTCOMES: Complication and survival rates were analyzed using logistic regression and Cox regression analyses, respectively. RESULTS: Of the 49,244 patients who had neutropenia during the study period, 134 (2.7%) were included. The median time from neutropenia onset to neutropenic enterocolitis was 2 days (interquartile range, 1-10 days). Neutropenic enterocolitis symptoms lasted for a median of 11 days (interquartile range, 6-22 days). Most patients received antibiotics (88%) and granulocyte colony-stimulating factor (68%). Complications included sepsis (11%), colonic perforation (2%), pneumatosis intestinalis (2%), and abscess formation (2%). The risks associated with complications included immunosuppressive therapy use within 1 month before neutropenic enterocolitis onset (OR, 3.92; 95% CI, 1.04-14.76) and delayed imaging (OR, 1.10; 95% CI, 1.03-1.17). Older age, severe neutropenia, prolonged neutropenia before and after neutropenic enterocolitis diagnosis, and other concomitant systemic infections were associated with lower survival rates. LIMITATIONS: The performance of this study at a single center and its retrospective nature are limitations of the study. CONCLUSION: The prompt diagnosis and management of neutropenic enterocolitis are critical to prevent complications. The use of granulocyte colony-stimulating factor can be beneficial to shorten the duration of neutropenia. See Video Abstract at http://links.lww.com/ DCR/B116.

Translated title of the contributionNeutropenic enterocolitis: Clinical features and outcomes
Original languageSpanish
Pages (from-to)381-388
Number of pages8
JournalDiseases of the colon and rectum
DOIs
StatePublished - Mar 1 2020

Keywords

  • Colitis
  • Neutropenia
  • Neutropenic colitis
  • Neutropenic enterocolitis
  • Typhlitis

ASJC Scopus subject areas

  • Gastroenterology

MD Anderson CCSG core facilities

  • Biostatistics
  • Microbiome Facility

Fingerprint

Dive into the research topics of 'Neutropenic enterocolitis: Clinical features and outcomes'. Together they form a unique fingerprint.

Cite this