Tinidazole efficacy for amebic colitis therapeutic prophylaxis in patients with de novo acute leukemia receiving intensive chemotherapy

Gac Med Mex. 2019;155(Suppl 1):S22-S27. doi: 10.24875/GMM.M19000285.

Abstract

Introduction: In Mexico, seroprevalence of Entamoeba histolytica is 8.4%. The intestinal amebiasis in patients with acute leukemia of novo, after the start of chemotherapy (CT) in the Hematology Service of the CMN 20 de Noviembre is 12%, even if patients show a negative baseline coprological test.

Objective: To find out if the administration of tinidazole, in patients with acute leukemia and negative coprological test, at the beginning of the CT, decreases the incidence of amoebic colitis during the induction to remission.

Method: Prospective and not comparative study. Patients with de novo diagnosis of acute leukemia who initiate induction and initial coprological CT. Tinidazole was indicated, 2 g/day for 5 days in the first week of CT started. They were monitored until the induction was concluded and hematopoietic recovery started.

Results: 38 patients, 15 women and 23 men with a mean age of 44 years (16-72), with acute lymphoblastic leukemia 19, myeloblastic 16 and promyelocytic 3. Cases without and with intestinal amebiasis were 35 and 3, respectively. Patients with amebiasis only received tinidazole for 3 days and it was given 2 days after the CT started.

Conclusion: Tinidazole, in patients with acute de novo leukemia who initiate induction CT, is effective in the prevention of intestinal amebiasis, during the induction stage, if administered at 2 g/day, for five days, starting on day 1 of the CT.

Keywords: Acute leukemia; Amebiasis; Chemotherapy; Tinidazole.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amebicides / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Dysentery, Amebic / parasitology
  • Dysentery, Amebic / prevention & control*
  • Female
  • Humans
  • Induction Chemotherapy / methods
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Male
  • Middle Aged
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Prospective Studies
  • Tinidazole / therapeutic use*
  • Young Adult

Substances

  • Amebicides
  • Tinidazole