DefinePK

Abstract

Objective: To evaluate the prevalence, risk factors and outcomes of neutropenia colitis in acute lymphoblastic leukemia during chemotherapy.
Methods: This prospective observational study was conducted from June to December 2024 at the Pediatric Hematology and Oncology unit of Indus Hospital & Health Network, Karachi, Pakistan, with ethical approval (IHHN_IRB_2024_01_012). Children aged 1–16 years with acute lymphoblastic leukemia (ALL) on active chemotherapy presenting with neutropenia (ANC <1500/?L), fever, abdominal symptoms, or hypoalbuminemia and radiologic gut wall thickening were enrolled, excluding those with other malignancies, relapsed disease, or palliative care. Using consecutive sampling, 63 patients were recruited. Data were collected via EMR and structured proforma, with multidisciplinary management and infection prevention counseling provided.
Results: A total of 64 children with neutropenic colitis were included, with a mean age of 7.15?±?1.19 years and a mean hospital stay of 15.14?±?12.45 days (range: 2–67 days). The cohort was predominantly male (67%) and mostly diagnosed with B-cell acute lymphoblastic leukemia (ALL), with 58% classified as high-risk and 23% as standard-risk. Most cases (69%) occurred during the induction phase of chemotherapy, followed by delayed intensification (13%) and consolidation (10%). Surgical intervention was the primary treatment strategy. Blood cultures were positive in 31% of cases, most commonly identifying E. coli (25%). Clinical outcomes showed an 89% recovery rate, with 11% mortality. Mean heart rate was 125 bpm, hemoglobin 7.5?g/dL, albumin 2.68?g/dL, creatinine 0.46?mg/dL, and ANC 135.9?cells/?L. Blood in stool emerged as a significant predictor of mortality (p?=?0.01).
Conclusion: Study concluded the severity and complexity of neutropenic colitis in children with acute leukemia and also clinical burden and risk factors associated with it.