Shafey Amy, Ethier Marie-Chantal, Traubici Jeffrey, Naqvi Ahmed, Sung Lillian
Departments of Pediatrics and Diagnostic Imaging, and Program in Child Health Evaluative Sciences, Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
J Pediatr Hematol Oncol. 2013 Oct;35(7):514-7. doi: 10.1097/MPH.0b013e31829f3259.
This retrospective chart review describes pediatric patients with acute lymphoblastic leukemia or acute myeloid leukemia diagnosed between January 1999 and January 2008, who were identified with enteritis, typhlitis, or colitis. Among the acute leukemia patients, 33/449 (7.3%) with acute lymphoblastic leukemia and 13/89 (14.6%) with acute myeloid leukemia experienced 51 episodes of enteritis (n=8), typhlitis (n=15), colitis (n=19), or enterocolitis (n=9). Twenty-five (49%) patients were exposed to corticosteroids within 14 days of the episode and 35 (68.6%) had fever and neutropenia concurrent with the episode. Forty-eight (94%) patients were treated with complete bowel rest and broad-spectrum antibiotics. However, 3 patients received no therapy and had uneventful courses. Complications included sepsis in 7/51 (13.7%) and intestinal obstruction in 3/51 (5.9%). One child required surgery for abscess drainage and 2 children died of causes unrelated to their colitis. Enteritis, typhlitis, or colitis occurred in 8.6% of children treated for leukemia. The optimal management approach is uncertain.
这项回顾性图表审查描述了1999年1月至2008年1月期间诊断为急性淋巴细胞白血病或急性髓细胞白血病且被确诊患有肠炎、盲肠炎或结肠炎的儿科患者。在急性白血病患者中，449例急性淋巴细胞白血病患者中有33例（7.3%），89例急性髓细胞白血病患者中有13例（14.6%）经历了51次肠炎（n = 8）、盲肠炎（n = 15）、结肠炎（n = 19）或小肠结肠炎（n = 9）发作。25例（49%）患者在发作后14天内使用了皮质类固醇，35例（68.6%）患者在发作时伴有发热和中性粒细胞减少。48例（94%）患者接受了完全肠道休息和广谱抗生素治疗。然而，3例患者未接受治疗，病程平稳。并发症包括7/51例（13.7%）发生败血症和3/51例（5.9%）发生肠梗阻。1名儿童因脓肿引流需要手术，2名儿童死于与结肠炎无关的原因。白血病患儿中8.6%发生肠炎、盲肠炎或结肠炎。最佳管理方法尚不确定。
