Tinidazole As Prophylaxis of Amoebic Colitis in Patients with Acute Leukemia of Recent Diagnosis during Induction Chemotherapy

Introduction Amebiasis is the third cause of death by parasitic disease (WHO 2007). In Mexico the seroprevalence of E . Hystolitica is of 8.4%. The prevalence known of intestinal amebiasis in patients with Acute Leukemia of recent diagnosis after Induction Chemotherapy is of 12%, causing fatal complications.

Objective The main objective was to learn if the dispensation of Tinidazole (TNZ) diminishes the incidence of amoebic colitis in patients with Acute Leukemia de Novo who had been treated with Induction Chemotherapy. The secondary objectives are to know the incidence of amoebic colitis and Acute Leukemia of recent diagnosis, as well as to identify the clinical and epidemiological characteristics and to recognize the fatality rate.

Material and Methods A non-comparative, longitudinal and open prospective study, was carried out to patients with Acute Leukemia de Novo who are starting Induction Chemotherapy. An initial stool test was taken from 38 patients and, simultaneously with the beginning of the therapy, they were given 2 grams of Tinidazole for 3 days, following up for 5 consecutive days. They continued in observation with final determination of complete stool test until hematologic recovery or for the following 4 weeks after starting chemotherapy and then the following up concluded.

Results Out of a total of 38 patients, 15 were women and 23 were men, all of the initial stool tests were negative. 19 patients were treated with chemotherapy for Acute Lymphoblastic Leukemia (ALL); 14 patients for Acute Myeloblastic Leukemia (AML) and 3 of them for Promyelocytic Leukemia (APL). The most frequent type of colitis was the neutropenic (p<0.03). There were 3 amoebic cases, 2 of them were treated with Tinidazole for three days and just 1 of them was treated with Tinidazole for 5 days (p= 0.04).

Conclusion It is proven that using Tinidazole in patients with Acute Leukemia of recent diagnosis that have started Induction Chemotherapy is effective on preventing amebiasis and complications.