acute myeloid leukemia.pdfVIP

Eur J Haematoll998: 61: 250-254 Printed in UK - all rights reserved Copyright 0 Munksgaard 1998 EUROPEAN JOURNAL OF HAEMATOLOGY ISSN 0902-4441 Intestinal permeability in patients with acute myeloid leukemia Sundstrom GM, Wahlin A, Nordin-Andersson I, Suhr OB. Intestinal permeability in patients with acute myeloid leukemia. Eur J Haematol 1998: 61: 250-254. 0 Munksgaard 1998. Intestinal permeability was studied in patients with acute myeloid leukemia (AML) before, during and after chemotherapy. Intestinal permeability was determined by the lactulose (La)/mannitol (Ma) absorption test in 16 adult patients with de n o w AML. The hydrogen breath test was used to disclose bacterial fermentation of the test substances in the small intestine. The permeability was found significantly increased (p 0.02) in the patients before induction chemotherapy treatment. During induction treatment and throughout the cytopenic period the intestinal permeability was constantly and significantly increased, compared with controls. In patients with abnormally increased permeability, no increase in hydrogen breath test result was noted. From our results it can be concluded that increased intestinal permeability is present in AML patients before commencing chemotherapy. Factors other than chemotherapy would seem to be more important regarding the occurrence of intestinal disturbances in these patients. As most cytotoxic drugs exert their effects mainly on proliferating cells, tissues containing a large proportion of dividing cells are usually vulnerable to their influence. The intestinal mucosa is one such tissue, where the cells are mostly replaced within a few days. Gastrointestinal complications often develop in patients with acute leukemia during and after chemotherapy, and the cytotoxic drugs used to treat AML have been shown in human and animal studies to damage the gastrointestinal mucosa (1-5). These complications may be the result of direct cytotox