Gastrointestinal Necrosis in Acute Leukemia: A Complication of Induction Therapy

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Abstract
Gastrointestinal complications in acute leukemia have been infrequently reported. A review of patients with acute leukemia from 1974-1980 and those with intestinal complications is presented. Of the 50 patients with acute leukemia, 14 (28%) developed an acute abdominal catastrophe. They presented with an acute surgical abdomen, diarrhea, gastrointestinal bleeding and a paralytic ileus. All were granulocytopenic and thrombocytopenic. All but 1 episode was associated with the death of the patients; survival ranged from 4-26 days (median 9 days) after their last dose of chemotherapeutic drugs. Cytarabine was administered in 13 of the 14 patients. Bowel necrosis which causes death in acute leukemia probably occurs more frequently than previously thought. There is a close association of the clinical syndrome with chemotherapeutic drugs, especially cytarabine.

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