Biomedical subjects
Publications and source records attributed to N Haim.
A 62-year-old woman developed fulminant neuteopenic colitis following aggressive chemotherapy for limited-stage small cell lung cancer. An urgently performed computerized tomographic [CT] study demonstrated the predominant involvement of the transverse colon. We present a brief description of the CT features of neutropenic colitis in this unusual presentation.
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Dose intensity may play an important role in the success of cancer chemotherapy. We have investigated the relationship between RDI of the combination of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) and the results of therapy in a group of 78 newly diagnosed patients with diffuse histiocytic and diffuse mixed non-Hodgkin's lymphoma. The achievement of CR was associated with high DI. In the initial cycles needed to achieve a maximal response, a significantly greater proportion of complete responders received average RDI, RDI of CTX and RDI of adriamycin greater than 0.8, as compared with noncomplete responders: 52 vs. 23%, 62 vs. 34% and 61 vs. 29%, respectively (P less than 0.05). Sixty-one patients achieved CR. Among these, RDI of CTX was best and significantly correlated with survival: 81 and 54% 5-year actuarial survival of patients receiving greater than 0.7 and less than 0.7 RDI, respectively (P less than 0.05). Our data indicate that there is a clear dose-rate effect of CHOP, particularly of CTX, on the therapeutic outcome. High DI may improve results of treatment in patients with diffuse, large cell lymphoma.
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Neutropenic colitis, a severe necrotizing enteropathy, is being recognized with increasing frequency as a life-threatening complication of aggressive chemotherapy mainly for lymphoproliferative and hematologic malignancies. It is often under-recognized clinically, despite its potentially lethal outcome. Both medical and surgical approaches to management are possible. We describe a case of neutropenic colitis involving predominantly the transverse colon in a patient successfully treated for limited-disease small cell lung cancer. This is only the second reported case of neutropenic colitis complicating chemotherapy for small cell lung cancer. A brief review of the diagnosis, clinical features, and management is presented.