International Journal of Hematology

, Volume 109, Issue 3, pp 351–355 | Cite as

Neutropenic enterocolitis in patients with FLT3 mutated acute myeloid leukemia undergoing induction chemotherapy with midostaurin

  • Jennifer DotsonEmail author
  • Adee Elhamdani
  • Ellen Petryna
  • Muhammad Omer Jamil
  • Mohamed Alsharedi
Case Report


Neutropenic enterocolitis mostly affects patients with acute myeloid leukemia (AML) who get treated with intensive chemotherapy which is associated with prolonged neutropenia; its pathogenesis is not well understood and the main factors in this life-threatening condition appear to be neutropenia, mucosal injury and a weakened immune system as a consequence of intensive chemotherapeutic agents. Midostaurin in combination with chemotherapy became the standard of care for FLT3 mutant AML since its approval by the United States Food and Drug Administration (FDA) in April 2017. Anecdotally in our institution, we noticed the common occurrence of neutropenic colitis in three out of three patients who were treated with midostaurin as part of induction chemotherapy for AML.


Neutropenic enterocolitis AML Midostaurin 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Gorschlüter M, Glasmacher A, Hahn C, Leutner C, Marklein G, Remig J, et al. Severe abdominal infections in neutropenic patients. Cancer Invest. 2001;19:669–77.CrossRefPubMedGoogle Scholar
  2. 2.
    Frick MP, Maile CW, Crass JR, Goldberg ME, Delaney JP. Computer tomography of neutropenic colitis. Am J Roentgenol. 1984;143:763–5.CrossRefGoogle Scholar
  3. 3.
    Stone RM, Mandrekar SJ, Sanford BL, Laumann K, Geyer S, Bloomfield CD, et al. Midostaurin plus chemotherapy for acute myeloid leukemia with a FLT3 mutation. N Engl J Med. 2017;377:454–64.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Gorschluter M, Mey U, Strehl J, Ziske C, Schepke M, Schmidt-Wolf IGH, et al. Neutropenic enterocolitis in adults: systematic analysis of evidence quality. Eur J Haematol. 2005;73:1–13.CrossRefGoogle Scholar
  5. 5.
    Thiede C, Steudel C, Mohr B, Schaich M, Schäkel U, Platzbecker U, et al. Analysis of FLT3-activating mutations in 979 patients with acute myelogenous leukemia: association with FAB subtypes and identification of subgroups with poor prognosis. Blood. 2002;99:4326–35.CrossRefPubMedGoogle Scholar
  6. 6.
    Katz J. Typhlitis: an 18-year experience and postmortem review. Cancer. 1990;65:1041–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Urbach DR, Rotstein OD. Typhlitis. Can J Surg. 1999;42(6):415.PubMedPubMedCentralGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  1. 1.Department of Hematology and OncologyMarshall UniversityHuntingtonUSA

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