Acute leukemia is defined as uncontrolled clonal proliferation of abnormal progenitor cells in the bone marrow and blood with detection of 20% blasts in peripheral blood and/or bone marrow or recurrent cytogenetic abnormalities defined by WHO.
Chemotherapy induces bone marrow suppression and prolonged neutropenia in acute leukemia patients, as a result, they are at a high risk of different types of infections. infections remain a major cause of therapy-associated mortality, and represent a frequent cause of treatment withdrawal.
Intestinal barrier dysfunction secondary to chemotherapy enables pathogens to penetrate the epithelium, resulting in bacterial translocation which can predispose to systemic infection and also chemotherapy causes dysbiotic changes in the microbiome with a shift to Gram-negative pathogenic species and colonisation of opportunistic pathogens, normalisation of intestinal homeostasis could be an appropriate strategy to reduce chemo-toxicity.
Prebiotic (as mannitol) administration results in improvement of barrier function in the gut.
AIM OF THE WORK:
The aim of this work was to investigate the role of osmotic debulking of gastrointestinal tract bacteria by mannitol at day one of starting chemotherapy on the incidence of sepsis in neutropenic patients diagnosed with acute leukemia and receiving induction chemotherapy.