Recent advances in neutropenic enterocolitis: Insights into the role of gut microbiota

Neutropenic enterocolitis (NE) is a life-threatening complication associated with neutropenia and the main cause of acute abdominal syndrome in neutropenic patients, especially those receiving intensive chemotherapy. This review aims to delineate actual insights into this clinical entity, to emphasi...

Full description

Saved in:
Bibliographic Details
Published in:Blood reviews 2022-07, Vol.54, p.100944-100944, Article 100944
Main Authors: Kapandji, Natacha, Azoulay, Elie, Zafrani, Lara
Format: Article
Language:English
Subjects:
Enterocolitis, Neutropenic - diagnosis
Enterocolitis, Neutropenic - etiology
Enterocolitis, Neutropenic - therapy
Gastrointestinal Microbiome
Hematology
Human health and pathology
Humans
Life Sciences
Microbiota
Neutropenia
Neutropenic enterocolitis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Neutropenic enterocolitis (NE) is a life-threatening complication associated with neutropenia and the main cause of acute abdominal syndrome in neutropenic patients, especially those receiving intensive chemotherapy. This review aims to delineate actual insights into this clinical entity, to emphasize diagnostic and therapeutic management, and to generate hypotheses on pathophysiology to identify avenues for research. Diagnosis is based on the association of neutropenia, fever, abdominal symptoms, and radiologic bowel wall thickening. Main complications are sepsis, perforations, and gastrointestinal bleeding. Several mechanisms may be responsible for mucosal injury: treatment-induced necrosis of the intestinal specific infiltrates, spontaneous intramural hemorrhage, or microvascular thrombosis. The prevailing cause is the direct cytotoxicity of chemotherapy. However, the role of gut dysbiosis in NE remains to be fully elucidated. Therapeutic management includes early multidrug antibiotherapy, transfusion support, hematopoietic growth factor treatment, fluid resuscitation, correction of electrolytes imbalance, and bowel rest. Indication and timing for surgical management are still debated.
ISSN:0268-960X
1532-1681
DOI:10.1016/j.blre.2022.100944