Akut lösemili hastalarda perianal hastalıkların prevalansı ve güncel yönetimi.

Aim: Perianal infection is one of the most important causes of infection in acute leukemia which puts the life of patients at risk, increases their morbidity and impairs quality of life. Material and Method: At the Ankara Atatürk Training and Research Hospital Hematology Clinic, 125 patients who received standard chemotherapy for acute leukemia between 2009 and 2017 werestudied, retrospectively. Results: Of these 125 acute leukemia patients, 25 (20%) developed perianal disease and 13 (10,4%) developed perianal infection. Perianal disease and infection developed in 34% and 21% of patients with ALL; in 16% and 7% of patients with AML (p=0.03 and p=0.04), respectively. Perianal disease was present in 29% of the patients with a leukocyte count greater than 10,000 at diagnosis, but remained at 12% in those with a leukocyte count below 10,000 (p=0.02). Perianal disease and perianal infection developed in 64% and 69% of the patients during induction and at a median of 13 days (range: 1-40) and 17 days (range: 3-34), respectively. It was observed that 60% of the patients with perianal disease had fever, 28% had positive blood culture, 16% had sepsis and 20% required surgical treatment. Among 7 patients with perianal disease and positive blood cultures, all had Gram (-) bacilli (5 Klebsiella pneumonia and 2 E. coli). Of the 6 patients who had masses in physical examination under went pelvic magnetic resonance imaging (MRI). All patients diagnosed with abscesses on MRI. Five patients who under went surgery; 3 abscess drainage, 1 colostomy and 1 polypectomy was performed. Conclusion: It was observed that perianal disease and infection developed more frequently in ALL patients compared with AML patients; perianal disease could be controlled mainly with conservative treatment and MRI could be an important guide in the management of these patients. [ABSTRACT FROM AUTHOR]