Results of high-risk neutropenia therapy of hematology–oncology patients in a university hospital in Uruguay

Burutaran, Matilde Boada; Guadagna, Regina; Grille, Sofía; Stevenazzi, Mariana; Guillermo, Cecilia; Díaz, Lilián

doi:10.1016/j.bjhh.2014.11.012

Cited by 12 publications

(20 citation statements)

References 22 publications

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“…These findings had been described in a historical review (34), and were confirmed in a recent study (8), where the extent and duration of neutropenia were significantly associated with the risk of infection.…”

Section: Discussionsupporting

confidence: 64%

“…CIN and related complications have an economic impact on health care providers (8). The mean cost for each neutropenia episode in our service was 9,386.5±6,688.9 Egyptian pounds, which was significantly lower compared with those reported in different economic analyses (39)(40)(41).…”

Section: Discussionmentioning

confidence: 58%

“…Similarly, FN was the most commonly recorded complication (61.4%) of systemic chemotherapy for hematological oncology adult patients in a recent study conducted in Uruguay (8). By contrast, Mahmud et al reported a significantly lower incidence (25-40%) of FN in their series (31).…”

Section: Discussionmentioning

confidence: 93%

“…Respiratory tract and skin infections were the most common according to Boada Burutaran et al (8), while Anunnatsiri et al reported urinary tract infection, soft tissue infection and bacteremia as the most common occurrences (32). Variable sites of infections may be associated with different invasive procedures that provide a portal of entry for pathogens (18).…”

Section: Discussionmentioning

confidence: 99%

“…Early recognition of FN and initiation of broad spectrum empirical systemic antibacterial therapy is crucial for avoiding progression to sepsis and possible death (7). CIN may also necessitate chemotherapy dose reductions, delays or even discontinuation, which may compromise treatment outcome (8).…”

Section: Introductionmentioning

confidence: 99%

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Chemotherapy-induced neutropenia among pediatric cancer patients in Egypt: Risks and consequences

Badr

Hassan

Sakr

et al. 2016

Molecular and Clinical Oncology

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Abstract. Chemotherapy-induced neutropenia (CIN) is the major dose-limiting toxicity of systemic chemotherapy and it is associated with significant morbidity, mortality and treatment cost. The aim of the present study was to identify the risk factors that may predispose pediatric cancer patients who receive myelosuppressive chemotherapy to CIN and associated sequelae. A total of 113 neutropenia episodes were analyzed and the risk factors for CIN were classified as patient-specific, disease-specific and regimen-specific, while the consequences of CIN were divided into infectious and dose-modifying sequelae. The risks and consequences were analyzed to target high-risk patients with appropriate preventive strategies. Among our patients, 28% presented with a single neutropenia attack, while 72% experienced recurrent attacks during their treatment cycles. The mean absolute neutrophil count was 225.5±128.5 x10 9 ̸l (range, 10-497 x10 9 ̸l), starting 14.2±16.3 days (range, 2-100 days) after the onset of chemotherapy and resolving within 11.2±7.3 days, either with (45.1%) or without (54.9%) granulocyte colony-stimulating factor (G-CSF). No significant association was observed between any patient characteristics or disease stage and the risk for CIN. However, certain malignancies, such as acute lymphocytic leukemia (ALL), neuroblastoma and Burkitt's lymphoma, and certain regimens, such as induction block for ALL and acute myelocytic leukemia, exerted the most potent myelotoxic effect, with severe and prolonged episodes of neutropenia. G-CSF significantly shortened the duration of the episodes and enhanced bone marrow recovery. Febrile neutropenia was the leading complication among our cases (73.5%) and was associated with several documented infections, particularly mucositis (54.9%), respiratory (45.1%), gastrointestinal tract (38.9%) and skin (23.9%) infections. A total of 6% of our patients succumbed to infection-related complications. Neutropenia was responsible for treatment discontinuation (13.3%), dose delay (13.3%) and dose reduction (5.3%) in our patients.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Chemotherapy-induced neutropenia among pediatric cancer patients in Egypt: Risks and consequences

Badr

Hassan

Sakr

et al. 2016

Molecular and Clinical Oncology

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Does age play a role in fever and neutropenia events and complications: A comparison of adolescents versus younger children with cancer at a tertiary care pediatric hospital, a pilot project

2022

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Background Adolescents and young adults with cancer (AYA) are a complex group of patients. The development of fever and neutropenia (FN) is a potentially lethal complication of chemotherapy. Risk stratification of patients with FN has become increasingly valuable allowing for early intervention and to guide treatment type and duration appropriately. There are risk stratification guidelines that exist, but most are validated in young children with cancer (YCWC). AYA are frequently shown to have more numerous and severe side effects from chemotherapy. Aims This study aimed to identify whether age contributes to the incidence and severity of FN. Methods and Results Patients diagnosed with a malignancy in a 5‐year period at our institution were included from ages 0–18 years. We reviewed details of their FN events, including duration of hospital admission, source (bacterial/fungal), PICU admission and duration, positive blood cultures and mortality. Adolescents with cancer (AWC) had a trend of being 1.56 times more likely to have FN events (CI 95% 0.936–2.622, p = 0.087). Assessment of the duration of PICU stay showed that AWC were 4.9 times more likely to have longer admissions (CI 95% 0.998–24.067, p = 0.050). There was no significant difference between the two groups in the rate of PICU admission, positive cultures, identification of a bacterial or fungal source, hospital admission duration or mortality from FN. Conclusion This study demonstrated a trend towards AWC being more likely to develop FN events. When such events occur in this group, the severity of them may be heightened as evidenced by longer duration of PICU admission.

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Impact of cardiovascular comorbidities on inpatient mortality in patients hospitalized with neutropenic fever

Atallah‐Yunes

Kadado

Haddadin

et al. 2020

Support Care Cancer

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Results of high-risk neutropenia therapy of hematology–oncology patients in a university hospital in Uruguay

Cited by 12 publications

References 22 publications

Chemotherapy-induced neutropenia among pediatric cancer patients in Egypt: Risks and consequences

Chemotherapy-induced neutropenia among pediatric cancer patients in Egypt: Risks and consequences

Does age play a role in fever and neutropenia events and complications: A comparison of adolescents versus younger children with cancer at a tertiary care pediatric hospital, a pilot project

Impact of cardiovascular comorbidities on inpatient mortality in patients hospitalized with neutropenic fever

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