Babakhanlou Rodrick, Ravandi-Kashani Farhad, Kontoyiannis Dimitrios P
Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
Division of Internal Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.
J Hematol. 2023 Apr;12(2):59-65. doi: 10.14740/jh1105. Epub 2023 Apr 30.
Neutropenic enterocolitis (NEC) is a life-threatening condition occurring in severely neutropenic patients, following intensive chemotherapy for leukemia. Its pathogenesis is not entirely understood and believed to be multifactorial, including mucosal injury as a result of cytotoxic drugs, profound neutropenia, impaired host defense and possibly microbiota changes. Establishing an early diagnosis is key. The management of NEC remains undefined due to lack of high-quality clinical data. With a better understanding of the disease, a more conservative approach is preferred over surgical intervention. The involvement of a multi-disciplinary team, consisting of the oncologist, infectious diseases specialists and surgeons is highly recommended. This review aims to delineate insights into the pathophysiology and clinical presentation of NEC and to emphasize the diagnostic and therapeutic approach to this condition.
中性粒细胞减少性小肠结肠炎(NEC)是一种发生在白血病患者接受强化化疗后严重中性粒细胞减少患者身上的危及生命的疾病。其发病机制尚未完全明确,被认为是多因素的,包括细胞毒性药物导致的黏膜损伤、严重的中性粒细胞减少、宿主防御功能受损以及可能的微生物群变化。早期诊断是关键。由于缺乏高质量的临床数据,NEC的治疗方法仍不明确。随着对该疾病的进一步了解,相较于手术干预,更倾向于采用更保守的方法。强烈建议由肿瘤学家、传染病专家和外科医生组成的多学科团队参与。本综述旨在阐述对NEC病理生理学和临床表现的见解,并强调针对这种疾病的诊断和治疗方法。