Successful conservative treatment of neutropenic enterocolitis complicating taxane-based chemotherapy - A report of five cases

Five cases of acute neutropenic enterocolitis complicating taxane-based che motherapy are described. During a 34-month period, our department administe red 4,600 courses of taxane-based (paclitaxel and docetaxel) chemotherapy t o 800 cancer patients. Seven to 10 days postchemotherapy in five patients ( 0.1% of the given courses), neutropenic fever, abdominal pain, rebound tend erness, and grade II-IV diarrhea (bloody in two cases) developed. Two patie nts had oral candidiasis, and in two others septic shock developed. Compute d tomography scans of the abdomen revealed in all patients thickening of th e colon wall and pericolic edema, and a pericolic abscess was revealed in t hree of them. Both clinical and radiologic findings supported the diagnosis of acute neutropenic enterocolitis. All patients were successfully treated with broad-spectrum antibiotics and recombinant human granulocyte colony-s timulating factor. In conclusion, acute neutropenic enterocolitis is a seve re complication of taxane-based chemotherapy. Early diagnosis and appropria te conservative treatment leads to complete recovery. Although rare, this i nfection is less often associated with other chemotherapeutic regimens.