FACTORS ASSOCIATED WITH TREATMENT OUTCOME OF PEDIATRIC CANCERPATIENTS ADMITTED WITH FEBRILE NEUTROPENIA IN TIKURANBESSA SPECIALIZED TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA

Selamawit Assefa | Bio
Addis Ababa University
Tinsae Alemayehu | Bio
Addis Ababa University
Workeabeba Abebe | Bio
Addis Ababa University
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  • Articles
  • Submited: February 2, 2016
  • Published: December 20, 2016

Abstract

Background: Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life-threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology.

Objective: To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia.

Method: We conducted a review of records of pediatric patients hospitalized and treated for chemotherapy-induced febrile neutropenia from January 1, 2013 to December 31, 2013 and met the selection criteria.

Result: A total of 60 patients (36 males and 24 females) fulfilled the selection criteria. Twelve of them died while in hospital. The mean (SD) age of patients who died was 4.78 (±2.48) years and the mean (SD) hospital stay before death was 20.2 (±5.26) days. Ten children had hematologic malignancy and two had a solid tumor. Ten of the 12 patients had an absolute neutrophil count  of less than 100/mm3 (p=0.008, OR=20.3) and a platelet count of less than 50,000/mm3. Six of the 10 children (10%) had sepsis. Patients with profound neutropenia, platelet count of less than 50,000 and sepsis were more likely to die (P=0.048, OR=7).

Conclusion: The result of this study showed that absolute neutrophil count of less than 100/mm3, platelet count of less than 50,000/mm3 and a diagnosis of sepsis were factors affecting outcome patients with febrile neutropenia. Careful evaluation of these factors and assessing severity of patients’ clinical condition at time of admission can be useful for triaging children with febrile neutropenia.

 

Keywords: fever, neutropenia, cancer, absolute neutrophil count , febrile neutropenia, oncologic emergency

 

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References

  1. Hakim H, Flynn P, Srivastava DK, Knapp K, Li C, Okuma J et al (2009); Risk prediction in pediatric cancer patients with fever and neutropenia. Pediatr Infect Dis J 2010;29: 53–59
  2. Debra LP (2011). The use of antimicrobial agents in children with fever during chemotherapy-induced neutropenia. Pediatr Infect Dis J 2011;30: 887–890
  3. Sung L, Johnston D (2007). Approach to febrile neutropenia in the general pediatric setting. Paediatr Child health 2007; 12(1): 19-21
  4. Mandell GL, Bennett JE, Doolin R, 6th eds (2005). Principles and practice of infectious diseases. Philadelphia: Churchill Livingstone, 2005:3442–62.
  5. Castagnola E, Fontana V, Caviglia I, Caruso S, Faraci M, Fioredda F et al (2007). A prospective study on the epidemiology of febrile episodes during chemotherapy-induced neutropenia in children with cancer or after hemopoietic stem cell transplantation. Clin Infect Dis 2007; 45:1296
  6. Ramphal R (2004). Changes in the etiology of bacteremia in febrile neutropenic patients and the susceptibilities of the currently isolated pathogens. Clinical Infectious Diseases 2004; 39:S25–31
  7. Hakim H, Flynn PM, Knapp KM (2009). Etiology and clinical course of febrile neutropenia in children with cancer. J Pediatr Hematol Oncol 2009; 31:623
  8. Gedik H, Yildirmak MT, Simsek F, Aydin D, Demirel N, Yokus O et al (2012). Fungal pathogens and primary anti-fungal prophylaxis in patients with hematologic malignancies. African Health Sciences 2012; 12(3): 390 – 394
  9. Licciardello M, Pegoraro A, Cesaro S (2010). Prophylaxis and therapy of viral infections in pediatric patients treated for malignancy. Pediatric reports 2011; volume 3:e5
  10. Koh A (2012). Prolonged febrile neutropenia in the pediatric patient with cancer. American Society of Clinical Oncology.1092-9118/10/1-10
  11. Santolaya M, Alvarez A, Aviles C, Becker A, Mosso C, O’Ryan M et al (2007). Admission clinical and laboratory factors associated with death in children with cancer during a febrile neutropenic episode. Pediatr Infect Dis J 2007;26: 794–798
  12. Basu SK, Fernandez ID, Fisher S, Asselin B, Lyman G (2005). Length of stay and mortality associated with febrile neutropenia among children with cancer. J Clin Oncol 23:7958-7966
  13. Badiei Z, Khalesi M, Alami MH, Kianifar HR, Banihashem A, Farhangi H et al (2011). Risk factors associated with life-threatening infections in children with febrile neutropenia. J Pediatr Hematol Oncol 2011: 33(1)
  14. Stabell N, Nordal E, Stensvold E, Gammelsrud KW, Lund B, Taxt A et al (2008). Febrile neutropenia in children with cancer: a retrospective Norwegian multicentre study of clinical and microbiological outcome. Scand J Infect Dis 2008;40(4):301-7
  15. Agyeman P, Kontny U, Nadal D, Leibundgut K, Niggli F, Simon A (2014). A prospective multi-center study of microbiologically defined infections in pediatric cancer patients with fever and neutropenia. Pediatr Infect Dis J 2014;33:e219–e225
  16. Timothy M, Bodkyn C (2011). The outcome of febrile neutropenic episodes in pediatric oncology at the Wendy Fitzwilliam pediatric hospital. West Indian Med J 2011; 60 (2): 153
  17. Baorto EP, Aquino VM, Mullen CA, Buchanan GR, DeBaun MR (2001). Clinical parameters associated with low bacteremia risk in 1100 pediatric oncology patients with fever and neutropenia. Cancer, 2001; 92 (4):909-13
  18. Klaasen RJ, Goodman TR, Pham B, Doyle JJ (2000). “Low risk” prediction rule for pediatric oncology patients presenting with fever and neutropenia. J Clinical Oncol 2000; 18(5):1012-19
  19. O’Connor D, Bate J, Wade R, clack R, Dhir S, Hough R et al (2016). Infection-related mortality in children with acute lymphoblastic leukemia: an analysis of infectious deaths. Blood 2014; 124(7): 1056-61
  20. Lucas K, Brown A, Armstrong D, Chapman D, Heller G (1996). The identification of febrile, neutropenic children with neoplastic disease at lower risk for bacteremia and complications of sepsis. Cancer 1996;77:791-8
How to Cite
Assefa, S., Alemayehu, T., & Abebe, W. (2016). FACTORS ASSOCIATED WITH TREATMENT OUTCOME OF PEDIATRIC CANCERPATIENTS ADMITTED WITH FEBRILE NEUTROPENIA IN TIKURANBESSA SPECIALIZED TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA. Ethiopian Medical Journal, 55(1). Retrieved from https://emjema.org/index.php/EMJ/article/view/315

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