Chang Hung, Kuo Ming-Chung, Tang Tzung-Chih, Lin Tung-Liang, Wu Jin-Hou, Hung Yu-Shin, Wang Po-Nan
Division of Hematology-Oncology, Chang Gung Memorial Hospital, Kweishan, Taiwan.
Acta Haematol. 2017;138(1):10-13. doi: 10.1159/000475589. Epub 2017 Jun 7.
Perianal abscess may develop during neutropenia periods in patients with acute myeloid leukemia (AML). The standard of care for perianal abscess in AML is unclear.
We retrospectively collected patient data in our institute from 2009 to 2012.
Two hundred ninety-two patients with AML were analyzed. In total, 1,051 chemotherapy sessions were administered. Twenty-three patients experienced perianal abscess. Patients with perianal abscess were younger than those without (44 vs. 60 years, p < 0.0001). Perianal abscess developed in various phases of treatment and in the stem cell transplantation period. Twelve recurrences developed in 6 patients. Patients with a prior perianal abscess have a 10-fold risk of developing a subsequent abscess following further chemotherapy. The microbiology profile revealed that most pathogens were derived from the intestinal tracts, which was similar to the findings of previous studies. The 28-day mortality was 14.3% and the direct cause of death was not perianal abscess in any case. Surgical interventions had no impact on recurrence or survival.
In patients with AML, perianal abscess results from gastrointestinal tract pathogens. Many patients do not require surgical interventions. The mortality is low but recurrence is common following subsequent chemotherapies. Therefore, awareness of recurrence is important for the timely management of perianal abscess in AML.
急性髓系白血病（AML）患者在中性粒细胞减少期可能会发生肛周脓肿。AML患者肛周脓肿的护理标准尚不清楚。
我们回顾性收集了我院2009年至2012年的患者数据。
对292例AML患者进行了分析。共进行了1051次化疗疗程。23例患者发生了肛周脓肿。发生肛周脓肿的患者比未发生者更年轻（44岁对60岁，p<0.0001）。肛周脓肿在治疗的各个阶段以及干细胞移植期均有发生。6例患者出现了12次复发。既往有肛周脓肿的患者在进一步化疗后发生后续脓肿的风险高出10倍。微生物学分析显示，大多数病原体来自肠道，这与先前研究的结果相似。28天死亡率为14.3%，死亡的直接原因在任何情况下均不是肛周脓肿。手术干预对复发或生存没有影响。
在AML患者中，肛周脓肿由胃肠道病原体引起。许多患者不需要手术干预。死亡率较低，但后续化疗后复发很常见。因此，对于AML患者肛周脓肿的及时管理，认识到复发很重要。
