Orhan Bedrettin, Özkalemkaş Fahir, Özkocaman Vildan, Gürbüz Büşra, Ersal Tuba, Pınar İbrahim Ethem, Yalçin Cumali, Candar Ömer, Çubukçu Sinem, Koca Tuba Güllü, Ali Rıdvan
Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.
Department of Internal Medicine, Faculty of Medicine, Bursa Uludag University, Bursa, Turkey.
Mediterr J Hematol Infect Dis. 2022 Jul 1;14(1):e2022051. doi: 10.4084/MJHID.2022.051. eCollection 2022.
Infections are the most common cause of anal and perianal pathologies in patients with hematological malignancies. Perianal infection diagnosis in this group of patients is difficult; thus, a careful anorectal examination is necessary with imaging modalities. In addition, the literature reveals a knowledge gap in the approach to anal pathologies in patients with neutropenia during diagnosis or chemotherapy. This study aimed to examine our institutional data on perianal complications and investigate the relationship between the white blood cell-neutrophil count, perianal lesion, and the type of treatment in patients with hematologic malignancies during the neutropenic period.
Patients with a hematologic malignancy, hospitalized for cytotoxic chemotherapy, complicated by perianal pathology, documented by at least one imaging method, were included in the study.
A total of 42 patients were included in the study. Most of them had acute leukemia, 31 were affected by acute myeloid leukemia (AML), and 7 by Acute lymphoid leukemia (ALL). There was no statistically significant relationship between the anal abscess formation, the neutrophil count, and a previous perianal pathology. Anal abscess development was significantly more frequent in acute myeloid leukemia. An inverse relationship was found between the total white blood cell number at onset and having a surgical intervention for anal pathology.In conclusion, this article has shown that white blood cell count at the time of hospitalization can affect the surgical intervention in patients with hematological malignancy (in the majority with acute leukemia) affected by anal pathologies occurring in the neutropenic period.
感染是血液系统恶性肿瘤患者肛门及肛周病变最常见的原因。这类患者的肛周感染诊断困难，因此需要通过影像学检查手段进行仔细的肛肠检查。此外，文献显示在中性粒细胞减少症患者诊断或化疗期间，对于肛门病变的处理方法存在知识空白。本研究旨在分析我院关于肛周并发症的数据，并调查血液系统恶性肿瘤患者中性粒细胞减少期白细胞-中性粒细胞计数、肛周病变与治疗类型之间的关系。
纳入因细胞毒性化疗住院且并发肛周病变的血液系统恶性肿瘤患者，至少通过一种影像学方法记录病情。
共纳入42例患者。其中大多数患有急性白血病，31例为急性髓系白血病（AML），7例为急性淋巴细胞白血病（ALL）。肛门脓肿形成、中性粒细胞计数与既往肛周病变之间无统计学显著关系。急性髓系白血病患者肛门脓肿的发生率明显更高。发病时的白细胞总数与因肛门病变接受手术干预之间呈负相关。总之，本文表明住院时的白细胞计数会影响血液系统恶性肿瘤（大多数为急性白血病）患者在中性粒细胞减少期发生肛门病变时的手术干预。
