中性粒细胞减少性小肠结肠炎(NE)是一种罕见但严重的并发症,发生在接受强化化疗的中性粒细胞减少患者中。死亡率很高,所以需要早期诊断才能开始紧急医疗或手术治疗。造血干细胞移植后NE发展的数据分析仍然很少。本病例系列的目的是讨论2016年至2020年在CheikhKhalifa国际大学医院血液科接受自体干细胞移植(ASCT)治疗多发性骨髓瘤合并NE的100名患者中的5名。卡萨布兰卡,摩洛哥。患者诊断为IgA和IgG多发性骨髓瘤,年龄在58至64岁之间。他们接受了包括蛋白酶体抑制剂在内的三联疗法的四个周期的诱导治疗,一种免疫调节药物,和皮质类固醇,允许完全缓解。强化基于使用200mg/m2的美法仑的ASCT。发育期的标志是NE的突然出现,根据临床诊断,生物,和成像标准。治疗包括抗生素治疗和支持治疗。我们报告病例没有并发症,也不需要手术治疗.因此,我们认为早期诊断和治疗可以在我们的病例系列中取得良好的进展。NE的管理必须是多学科的血液学家,胃肠病学家,放射科医生,和生物学家。需要更多的研究和试验来建立具体的诊断标准和更好的治疗方案。
Neutropenic enterocolitis (NE) is a rare but severe complication occurring in neutropenic patients undergoing intensive chemotherapy. Mortality is high, so early diagnosis is required to start urgent medical or surgical treatment. Data analysis of the development of NE after hematopoietic stem cell transplantation remains scarce. The aim of this case series is to discuss five out of 100 patients receiving autologous stem cell transplants (ASCTs) for multiple myeloma complicated with NE between 2016 and 2020 in the hematology department of the Cheikh Khalifa International University Hospital, Casablanca, Morocco. The patients were diagnosed with IgA and IgG multiple myeloma and aged between 58 to 64 years. They received induction therapy with four cycles of a triplet regimen including a proteasome inhibitor, an immunomodulatory drug, and corticosteroids, allowing a complete remission. Intensification was based on ASCT with melphalan at 200 mg/m2. The period of aplasia was marked by the sudden appearance of NE, diagnosed based on clinical, biological, and imaging criteria. Treatment included antibiotherapy and supportive care. We report no complications in our cases, nor the need for surgical care. Therefore, we consider that early diagnosis and treatment allowed a good evolution in our case series. The management of NE must be multidisciplinary associating hematologists, gastroenterologists, radiologists, and biologists. More studies and trials are needed to establish specific diagnostic criteria and better treatment options.