1218. Risk Factors for Neutropenic Enterocolitis in Adults with Acute Leukemia
Session: Poster Abstract Session: Transplant: Epidemiology of Infections in Transplant Patients and Other Patients with Impaired Immunity
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDWEEK poster, 7-11 October 2015.pdf (498.4 kB)
  • Background: Neutropenic enterocolitis (NEC) occurs in nearly 5% of acute leukemia patients. Risk factors other than neutropenia are not systematically studied. We aimed to determine risk factors of this disease in a large acute leukemia cohort. 

    Methods: Six hundred post-chemotherapy neutropenia episodes in 123 acute myeloid and 56 acute lymphoblastic leukemia patients (median age 44 years, range 16-77; 80 female, 99 male) which had been prospectively recorded between January 2005 and April 2013, were analyzed. The diagnosis of NEC was done by the combination of clinical and radiological criteria as described by Gorschlüter, et al (Eur J Haematol 2005 ;75:1). Univariate analysis to define risk factors associated with NEC were done by Chi-square or independent samples T-test for categorical and continuous variables, respectively. Factors associated with NEC (p< .1) were included in binary logistic regression analysis to determine independent risk factors. 

    Results: NEC was observed in 33  of 600 (5.5%) neutropenic episodes.  Use of prophylactic levofloxacin (p=.015), type of chemotherapy (induction, consolidation or conditioning) (p< .01), duration of neutropenia  (p< .01) and hypertension (p= .054) as a comorbidity were associated with NEC in univariate analysis. Whereas, type of leukemia, age, gender, presence of mucositis, corticosteroid use and comorbidities other than hypertension were found to be unrelated. Only duration of neutropenia (odds ratio [95% CI] = 1.045[1.008-1.083], p= 0.017) and levofloxacin prophylaxis (odds ratio [95% CI] = 0.372[0.153-0.906], p= 0.030) remained as significant independent risk factors in the multivariate analysis. Relative odds for NEC increased by 4.5% for each additional day of neutropenia. 

    Conclusion: Prolonged neutropenia seems to be the main risk factor for developing NEC. Levofloxacin prophylaxis can prevent this complication.

    Sezgin Etgul, MD1, Yahya Buyukasik, MD1, Tuncay Aslan, MD1, Gursel Gunes, MD1, Umit Yavuz Malkan, MD1, Seda Aydin, MD1, Pinar Zarakolu, MD2 and Murat Akova, MD2, (1)Hematology, Hacettepe University, Ankara, Turkey, (2)Infectious Diseases, Hacettepe University, Ankara, Turkey

    Disclosures:

    S. Etgul, None

    Y. Buyukasik, None

    T. Aslan, None

    G. Gunes, None

    U. Y. Malkan, None

    S. Aydin, None

    P. Zarakolu, None

    M. Akova, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.