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Typhlitis in Children with Cancer

Nicklas Sundell, Håkan Boström, Mats Edenholm, Jonas Abrahamsson
AIM: To describe the symptoms, clinical management and short-term outcome in a series of paediatric oncology patients with severe typhlitis following conservative treatment. METHODS: Twelve episodes of severe typhlitis in 11 children with cancer treated at the paediatric oncology ward at Queen Silvias Children's Hospital between 1995 and 2006 were analysed retrospectively. Data on symptoms, radiological findings, laboratory status and treatment as well as outcome were collected and analysed...
March 2012: Acta Paediatrica
Frankie B Fike, Vincent Mortellaro, David Juang, Shawn D St Peter, Walter S Andrews, Charles L Snyder
BACKGROUND: Neutropenic colitis (NC) or typhlitis has an incidence of approximately 5% in patients receiving chemotherapy for malignancy. The precise cause is unknown, but almost all patients are neutropenic; most profoundly so. We reviewed our experience with neutropenic colitis over the past 10 y to assess the incidence, management, and outcome. MATERIALS AND METHODS: Hospital records were reviewed after obtaining IRB approval (# 10-10-184E). There were 1224 children treated for cancer at our institution over the study interval...
September 2011: Journal of Surgical Research
Wael El-Matary, Maryam Soleimani, Donald Spady, Mark Belletrutti
In a case-control study, medical records of all children (below 18 y of age) who were diagnosed with any malignancy between January 1988 and December 2008 were reviewed. Children who developed typhlitis during the course of their malignancy were identified. Age and sex-matched controls who were diagnosed with malignancy during the same time period but did not develop typhlitis were identified (1:4 ratio). The variables that were examined included underlying malignancy, chemotherapy, and final outcome. A total of 410 children (226 males, mean age of 87...
April 2011: Journal of Pediatric Hematology/oncology
Hadar Moran, Isaac Yaniv, Shai Ashkenazi, Michael Schwartz, Salvador Fisher, Itzhak Levy
Data on the risk factors for typhlitis in children with cancer are limited. The aim of the study was to define the epidemiologic and clinical features of typhlitis and to elucidate predisposing factors for its development. The medical records of pediatric patients with cancer who were diagnosed with typhlitis from 1995 to 2005 were reviewed for clinical, laboratory, and imaging findings. The results were compared with a group of patients with cancer but without typhlitis who were hospitalized during the same period...
September 2009: Journal of Pediatric Hematology/oncology
Nabil J Khoury, Vladimir Kanj, Miguel Abboud, Samar Muwakkit, Ghina A Birjawi, Maurice C Haddad
OBJECTIVE: To describe the imaging findings of abdominal complications caused by chemotherapy in pediatric cancer patients. SUBJECTS AND METHODS: Radiology studies of 243 patients treated in our Children Cancer Center were reviewed, 164 of whom had abdominal studies. Medical records of 54 patients with abnormal imaging findings were studied. RESULTS: Ultrasound and/or CT findings showed the following complications: (1) gallbladder sludge/crystals (n=13), gallstones (n=8), cholecystitis (n=3); (2) liver steatosis (n=23), siderosis (n=1), veno-occlusive disease (n=2); (3) pancreatitis (n=7); (4) typhlitis (n=12), esophagitis (n=2)...
July 2009: Clinical Imaging
Cathy Haut
Cancer statistics in children are promising as mortality rates consistently decrease, reflecting newer chemotherapeutic agents and the evolution of hematopoietic stem cell transplant. Typhilitis or neutropenic enterocolitis is a potentially life-threatening complication of cancer treatment often found in immunocompromised children receiving vigorous chemotherapeutic regimens and noted in children post-stem-cell transplant. Recent literature suggests a relationship between typhilitis and other types of cancers and immunocompromised illness occurring in both children and adults...
September 2008: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
Terzah M Horton, Matthew M Ames, Joel M Reid, Mark D Krailo, Thomas Pendergrass, Revonda Mosher, Gregory H Reaman, Nita L Seibel
BACKGROUND: This report summarizes a phase 1 study conducted by the Children's Cancer Group (CCG) to determine the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), pharmacokinetics, and anti-leukemia activity of paclitaxel in children with advanced stage leukemias. PROCEDURE: This study examined two dose escalation schedules of intravenous paclitaxel. Doses ranged from 250 to 500 mg/m(2) every 21 days in schedule A and 105 to 200 mg/m(2) weekly x 3 every 28 days in schedule B...
April 2008: Pediatric Blood & Cancer
M Beth McCarville, C Scott Adelman, Chenghong Li, Xiaoping Xiong, Wayne L Furman, Bassem I Razzouk, Ching-Hon Pui, John T Sandlund
BACKGROUND: Typhlitis is increasingly recognized in children undergoing chemotherapy but is poorly characterized. The authors investigated the demographic, clinical, and imaging (ultrasonography and computed tomography [CT] scans) variables related to the diagnosis, risk, and outcome of typhlitis. METHODS: The authors reviewed the records of patients who had typhlitis (bowel wall thickness > or = 0.3 cm plus clinical findings) during treatment at St. Jude Children's Research Hospital (Memphis, TN) between 1990 and 2001...
July 15, 2005: Cancer
M Beth McCarville, Janell Thompson, Chenghong Li, C Scott Adelman, Moon O Lee, Dania Alsammarae, Martha V May, Sandra C Jones, Bhaskar N Rao, John T Sandlund
BACKGROUND: The management of pediatric oncology patients with imaging evidence of appendiceal thickening is complex because they are generally poor surgical candidates and often have confounding clinical findings. OBJECTIVE: We sought to determine the significance of appendiceal thickening in pediatric oncology patients who also had typhlitis. Specifically, we evaluated the impact of this finding on the duration of typhlitis, its clinical management, and outcome...
March 2004: Pediatric Radiology
Marc Schlatter, Kristen Snyder, David Freyer
BACKGROUND/PURPOSE: The optimal management for typhlitis in pediatric oncology patients has not always been clear from the medical literature. Trends have varied between operative and nonoperative approaches. The aim of this study was to review the successful nonoperative management of these patients at our institution over the last decade to further clarify management guidelines for this difficult problem. METHODS: Medical records of pediatric hematology and oncology patients up to 21 years of age with typhlitis diagnosed at the DeVos Children's Hospital from 1990 to 2000 were reviewed...
August 2002: Journal of Pediatric Surgery
K M Kelly, R J Hutchinson, R Sposto, M A Weiner, M A Lones, S L Perkins, V Massey
BACKGROUND: Treatment strategies involving dose intensification have recently demonstrated improvements in cure compared with older trials. However, dose-intensive therapy is associated with increased acute and long-term toxicities, particularly in pediatric patients. The Children's Cancer Group initiated this pilot study to assess the feasibility and toxicity of a moderate dose-intensive regimen, BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone), in children and adolescents with advanced-stage Hodgkin's lymphoma (HL)...
2002: Annals of Oncology: Official Journal of the European Society for Medical Oncology
L Boggio, R Pooley, S I Roth, J N Winter
Three cases of typhlitis occurring during autologous blood stem cell transplantation (ABSCT) for metastatic breast cancer are described. Typhlitis is a rare complication of neutropenia and has uncommonly been reported in the autologous transplant setting. Although it has been most commonly described in children with leukemia, typhlitis has increasingly been reported in adult leukemias and in association with neutropenia secondary to chemotherapy for a number of solid tumors. Only five previous cases of typhlitis in the setting of ABSCT have been described...
February 2000: Bone Marrow Transplantation
E S Wiener
This article highlights the surgeon's role in childhood cancer especially as it relates to local control of solid tumors, research, and surgical supportive care. There is a trend toward preresection chemotherapy, and rarely, radiotherapy. This may allow safer, less extensive, and function-preserving delayed resection in neuroblastoma, hepatoblastoma, bone tumors, and nephroblastoma in selected patients without negatively affecting outcome. Ultimately, complete resection for most tumors, even advanced neuroblastomas, significantly improves survival...
February 1993: Current Opinion in Pediatrics
M M Sloas, P M Flynn, S C Kaste, C C Patrick
We identified 24 children treated for malignancies between 1962 and 1992 who had antemortem diagnoses of typhlitis that were confirmed on review. The study criteria specified the presence of fever, abdominal pain, and tenderness, with radiological evidence of right-sided colonic inflammation. Typhlitis was most frequent in patients treated for acute leukemias. Computed tomography and ultrasonography were more sensitive than plain radiography (false-negative rates, 15%, 23%, and 48%, respectively). The wider availability of these sensitive procedures and the increased intensity of chemotherapeutic regimens may account for a marked increase in the incidence of typhlitis over the past 5 years...
September 1993: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
C A Angel, B N Rao, E Wrenn, T E Lobe, A P Kumar
Of 6,099 children treated for malignancy, 16 (ages 3.5 to 18 years) developed acute appendicitis between 1962 and 1989. Fourteen had leukemia (ALL 10, AML 4). One each had rhabdomyosarcoma and Ewing's sarcoma. Active malignancy at diagnosis was noted in 10, 4 of whom had severe neutropenia (absolute neutrophil count less than 500/mm3). Of all the leukemics (2,794/6,099), abdominal pain during induction was a frequent complaint. The incidence of appendicitis, however, was low (0.5%). Nine of the 16 patients presented classically, facilitating prompt diagnosis and treatment...
April 1992: Journal of Pediatric Surgery
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