Objective
To determine the gastrointestinal toxic effects of idarubicin and cytosine arabinoside
combination therapy in patients with newly diagnosed acute myelogenous leukemia (AML).
Patients and Methods
We performed a single-institution retrospective analysis of the incidence of neutropenic
colitis in patients with newly diagnosed AML receiving idarubicin and cytosine arabinoside
combination therapy. Using pharmacy records, we identified 78 patients who received
idarubicin during the study period of January 1997 to September 1998 and who agreed
to a review of their medical records. Patients with preexisting bowel conditions were
excluded from this analysis. We used a strict definition of neutropenic colitis that
included clinical findings (severe abdominal pain, diarrhea, hematochezia, and/or
peritoneal signs) plus radiographic evidence of bowel inflammation in the absence
of an identified bacterial pathogen.
Results
Of the 78 patients receiving idarubicin and cytosine arabinoside for treatment of
AML, 65 were included in this study. We observed neutropenic colitis in 10 of these
65 AML patients. This complication was followed by sepsis in 3 patients and was the
major cause of death in 4 of the 8 patients who died.
Conclusion
This analysis suggests that neutropenic colitis is a frequent and serious complication
of idarubicin and cytosine arabinoside treatment.
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© 2002 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
