Skip to main content
NCBI home page
Postgraduate Medical Journal logoLink to Postgraduate Medical Journal
. 1986 Oct;62(732):915–918. doi: 10.1136/pgmj.62.732.915

Surgery for the acute abdomen in adults with leukaemia.

R W Martell, P Jacobs
PMCID: PMC2419037  PMID: 3464938

Abstract

In a retrospective analysis five of 104 patients with acute leukaemia undergoing cytotoxic chemotherapy developed abdominal signs requiring emergency surgical exploration. Two common features in these patients were the inclusion of cytosine arabinoside in their treatment regimen and a necrotizing lesion involving the terminal ileum, appendix, and right colon. Appendicectomy was performed in two and hemicolectomy in three. Of the patients receiving high-dose cytosine arabinoside one died in the immediate post-operative period and two after recovery from surgery but before marrow regeneration; the remaining two patients received conventional dose cytosine arabinoside, and both recovered. The inclusion of this agent is standard in modern treatment programmes, resulting in significant improvement in long-term disease-free survival, so that a greater awareness of this complication is necessary. Early surgery, utilizing modern support techniques, is recommended as feasible and appears to offer the only realistic chance of survival.

Full text

PDF
915

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Exelby P. R., Ghandchi A., Lansigan N., Schwartz I. Management of the acute abdomen in children with leukemia. Cancer. 1975 Mar;35(3):826–829. doi: 10.1002/1097-0142(197503)35:3<826::aid-cncr2820350339>3.0.co;2-b. [DOI] [PubMed] [Google Scholar]
  2. Jacobs A. D., Gale R. P. Recent advances in the biology and treatment of acute lymphoblastic leukemia in adults. N Engl J Med. 1984 Nov 8;311(19):1219–1231. doi: 10.1056/NEJM198411083111905. [DOI] [PubMed] [Google Scholar]
  3. Johnson H., Smith T. J., Desforges J. Cytosine-arabinoside-induced colitis and peritonitis: nonoperative management. J Clin Oncol. 1985 May;3(5):607–612. doi: 10.1200/JCO.1985.3.5.607. [DOI] [PubMed] [Google Scholar]
  4. Jones G. T., Abramson N. Gastrointestinal necrosis in acute leukemia: a complication of induction therapy. Cancer Invest. 1983;1(4):315–320. doi: 10.3109/07357908309063294. [DOI] [PubMed] [Google Scholar]
  5. Kies M. S., Luedke D. W., Boyd J. F., McCue M. J. Neutropenic enterocolitis: two case reports of long-term survival following surgery. Cancer. 1979 Feb;43(2):730–734. doi: 10.1002/1097-0142(197902)43:2<730::aid-cncr2820430249>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  6. Leach W. B., Laster W. R., Jr, Mayo J. G., Griswold D. P., Jr, Schabel F. M., Jr Toxicity studies in mice treated with 1-beta-D-arabinofuranosylcytosine (ara-C). Cancer Res. 1969 Mar;29(3):529–535. [PubMed] [Google Scholar]
  7. Lehman J. A., Armitage J. O. Surgical intervention in complications of acute leukemia. Postgrad Med. 1980 Nov;68(5):89-92, 95. doi: 10.1080/00325481.1980.11715591. [DOI] [PubMed] [Google Scholar]
  8. Lister T. A., Rohatiner A. Z. The treatment of acute myelogenous leukemia in adults. Semin Hematol. 1982 Jul;19(3):172–192. [PubMed] [Google Scholar]
  9. Mackinnon A. E., Hann I. M., Morris-Jones P. Childhood leukaemia and surgery. Br J Surg. 1982 Dec;69(12):731–733. doi: 10.1002/bjs.1800691216. [DOI] [PubMed] [Google Scholar]
  10. Rasmussen B. L., Freeman J. S. Major surgery in leukemia. Am J Surg. 1975 Dec;130(6):647–651. doi: 10.1016/0002-9610(75)90414-6. [DOI] [PubMed] [Google Scholar]
  11. Seligman B. R., Rosner F., Ritz N. D. Major surgery in patients with acute leukemia. Am J Surg. 1972 Nov;124(5):629–633. doi: 10.1016/0002-9610(72)90101-8. [DOI] [PubMed] [Google Scholar]
  12. Sherman N. J., Woolley M. M. The ileocecal syndrome in acute childhood leukemia. Arch Surg. 1973 Jul;107(1):39–42. doi: 10.1001/archsurg.1973.01350190029008. [DOI] [PubMed] [Google Scholar]
  13. Slavin R. E., Dias M. A., Saral R. Cytosine arabinoside induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols: a clinical-pathologic study of 33 patients. Cancer. 1978 Oct;42(4):1747–1759. doi: 10.1002/1097-0142(197810)42:4<1747::aid-cncr2820420413>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  14. Steinberg D., Gold J., Brodin A. Necrotizing enterocolitis in leukemia. Arch Intern Med. 1973 Apr;131(4):538–544. doi: 10.1001/archinte.1973.00320100066008. [DOI] [PubMed] [Google Scholar]
  15. Varki A. P., Armitage J. O., Feagler J. R. Typhlitis in acute leukemia: successful treatment by early surgical intervention. Cancer. 1979 Feb;43(2):695–697. doi: 10.1002/1097-0142(197902)43:2<695::aid-cncr2820430242>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  16. Wagner M. L., Rosenberg H. S., Fernbach D. J., Singleton E. B. Typhlitis: a complication of leukemia in childhood. Am J Roentgenol Radium Ther Nucl Med. 1970 Jun;109(2):341–350. doi: 10.2214/ajr.109.2.341. [DOI] [PubMed] [Google Scholar]
  17. Yates J., Glidewell O., Wiernik P., Cooper M. R., Steinberg D., Dosik H., Levy R., Hoagland C., Henry P., Gottlieb A. Cytosine arabinoside with daunorubicin or adriamycin for therapy of acute myelocytic leukemia: a CALGB study. Blood. 1982 Aug;60(2):454–462. [PubMed] [Google Scholar]

Articles from Postgraduate Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES