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Annals of Oncology Advance Access originally published online on October 5, 2006
Annals of Oncology 2007 18(1):183-189; doi:10.1093/annonc/mdl337
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© 2006 European Society for Medical Oncology

supportive care

Diarrhea in neutropenic patients: a prospective cohort study with emphasis on neutropenic enterocolitis

DY Aksoy1, MD Tanriover1,*, O Uzun2, P Zarakolu2, S Ercis3, S Ergüven3, A Oto4, U Kerimoglu5, M Hayran6 and O Abbasoglu7

1 Department of Medicine
2 Section of Infectious Diseases, Department of Medicine
3 Department of Microbiology and Clinical Microbiology, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara 06100, Turkey
4 Department of Radiology, University of Texas, Medical Branch at Galveston, Galveston, Texas
5 Department of Radiology
6 Department of Preventive Oncology, Institute of Oncology
7 Department of General Surgery, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara 06100, Turkey

* Correspondence to: Dr M. D. Tanriover, Department of Medicine, Section of General Internal Medicine, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara 06100, Turkey. Tel: +90 312 305 30 29; Fax: +90 312 310 41 79; E-mail: mdurusu{at}hacettepe.edu.tr

Background: Although diarrhea is a frequent complication in neutropenic patients, its true incidence, risk factors and clinical course have not been investigated prospectively.

Patients and methods: The study was carried out at Hacettepe University Hospital for Adults and involved patients over 16 years of age. Patients with malignant diseases who were neutropenic on admission or who became neutropenic during their stay in the wards between January 2001 and February 2003 were included. They were monitored daily until discharge, exitus, or recovery from neutropenia—whichever occurred earlier—to monitor the presence of diarrhea and other infections.

Results: A total of 317 neutropenic episodes in 215 patients were followed. Diarrhea was observed in 18.6% episodes, and the incidence of NEC was 3.5%. The etiology in 27% episodes of diarrhea could not be identified. The use of anthracyclines and mitoxantrone increased the incidence of diarrhea. Prior use of penicillin derivatives plus beta-lactam inhibitors and N-imidazoline derivatives was associated with decreased incidence of diarrhea.

Conclusions: Diarrhea is a common complication in neutropenic patients. Not only specific conditions like NEC, but also nonspecific diseases like parasitosis may be the cause of diarrhea in this patient population.

Key words: cancer, diarrhea, leukemia, neutropenia, neutropenic enterocolitis


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