NEUTROPENIC COLITIS AS A COMPLICATION OF HIGH-DOSE CHEMOTHERAPY FOR REFRACTORY TESTICULAR CANCER

A 44-year-old man received high-dose chemotherapy with carboplatin, et oposide and cyclophosphamide followed by autologous peripheral-blood s tem-cell transplantation for treatment of refractory nonseminomatous t esticular cancer (seminoma plus choriocarcinoma). The patient develope d fever, watery diarrhea and abdominal pain at 10 days after the initi ation of high-dose chemotherapy. Radiological examinations revealed ad ynamic ileus with thickened colon and small bowel wall and increasing ascites over the next 3 days. The patient subsequently suffered from d isseminated intravascular coagulation, renal failure and hyperbilirubi nemia despite systemic antibiotic therapy, intensive medical care coul d barely avoid the fatal outcome. Neutropenic colitis has been recogni zed as a complication of acute leukemia or aplastic anemia. The presen t case indicates that this serious gastrointestinal complication can o ccur under profound neutropenic conditions induced by intensive chemot herapy for solid cancer.