A Close Look at Neutropenia among Cancer Patients — Risk Factor and Management

Hassan, Bassam Abdul Rasool; Yusoff, Zuraidah Binti Mohd; Othman, SaadBin

doi:10.5772/60794

Cited by 3 publications

(4 citation statements)

References 42 publications

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“…67 (39,88) 26 (15,48) 20 (11,9) 24 (14,29) 11 (6,55) 20 (11,9) Chemotherapy The CISNE scores effectively predicted febrile neutropenia complications resulting from chemotherapy treatment of a solid malignancy with an AUROC of 0.893 (CI 95% 0.829-0.95; p = 0.03), whereas the MASCC scores with an AUROC of 0.77 (CI 95% 0.68-0.86; p = 0,04). Therefore, CISNE scores were found to be signi cantly better at predicting complications than MASCC scores in solid malignancy.…”

Section: Resultsmentioning

confidence: 99%

“…These ndings showed a difference in the prevalence of tumors in our study location, because as the national referral hospital we received many end-stage cancer patients with different types of tumor distribution. [14,15] In hematologic malignancy subjects, 87.67% of patients had non-Hodgkin's lymphoma. We excluded patients with acute leukemia because febrile neutropenia in acute leukemia patients, according to the IDSA guidelines, are in the high-risk category, regardless of their MASCC scores.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of CISNE and MASCC Score in Predicting Complications on Post Chemotherapy Febrile Neutropenia

Shakinah

Nelwan

Lubis

et al. 2021

Preprint

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Objective Despite the routine use of MASCC score in febrile neutropenia patients, researches showed that serious complications still occur in 15-42% of low-risk patients; therefore, a new scoring system Clinical Index of Stable Febrile Neutropenia (CISNE) is developed to predict the complication better. This retrospective cohort study aimed to assess the role of CISNE score compared to MASCC score as a risk stratification in post-chemotherapy FN in solid and hematologic malignancy. Patients who underwent inpatient treatment with FN between July 2015 and December 2019 were grouped based on both scores, while complications during inpatient was recorded. Both score's areas under the receiver operating characteristics curve were compared using DeLong method. Results CISNE score showed a better performance both in solid malignancy with AUC of CISNE score (0.893; 95% CI 0.829 - 0.95, p = 0.03) compared to AUC of MASCC score (0.77; 95% CI 0.68 – 0,86, p = 0.04) and in hematologic malignancy with AUC of CISNE score (0.91; 95% CI 0.84 - 0.97, p = 0.03) and AUC MASCC score (0.735 ; 95% CI 0.68 - 0.86, p = 0.04). CISNE score showed a better diagnostic performance with cut-off point value of 2.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of CISNE and MASCC Score in Predicting Complications on Post Chemotherapy Febrile Neutropenia

Shakinah

Nelwan

Lubis

et al. 2021

Preprint

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“…Immunosuppressive/cytotoxic chemotherapies target the rapidly dividing cells of the body and produce dose-dependent toxicity on cell production, protein synthesis, bone marrow, and cell survival, and their mechanism of drug-inducing immunological reaction results in cell destruction and hence leads to neutropenia. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

A sequential exploratory study to develop and validate neutropenic nursing care bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand

Dahiya

Rani

Nath

2022

Journal of Education and Health Promotion

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BACKGROUND: Patients diagnosed with cancer and who undergo cancer treatment are at potential risk of bone marrow suppression leading to prolonged hospitalization, delay in treatment, and chemotherapy dose reductions, which ultimately results in significant morbidity and mortality. This sequential exploratory study using a mixed-method approach was aimed to develop and validate a neutropenic nursing care (NNC) bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand. MATERIAL AND METHODS: This sequential exploratory study design with an instrument developmental model was used to develop the NNC bundle. It consisted of two phases: Qualitative phase and quantitative phase. In the qualitative phase, focused group discussion with eight oncology nurses was performed to derive themes related to neutropenic nursing care using conventional content analysis. An extensive literature review was also performed on these themes to explore the current pieces of evidence for item pool generation. In the quantitative phase, a preliminary draft bundle was developed, and two Delphi rounds (I and II) were carried out among the five experts for the content validation of the NNC bundle and a final bundle was developed. RESULTS: Major domains identified for the bundle were hand hygiene, care of central and peripheral lines, routine oral care, antiseptic bath, peri-anal care, diet, and environmental hygiene. The content validity index (CVI) of the bundle was found to be >80% for all the items with I-CVI >0.8 and S-CVI = 0.99 after conducting two rounds of Delphi. CONCLUSION: The present study has provided a set of valid written neutropenic nursing interventions to prevent complications in neutropenic patients. The NNC bundle should be subjected to other levels of evaluation that measure the bundle's practicability and suitability for the intended field.

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“…Hassan et al reported that the incidence of neutropenia was predominant among individuals aged 65 years or more compared to younger than 65 years of age[39] and explained his findings by the fact that Neutropenia is more common among the older age group (65 years and more) because their ability to produce mature neutrophil is reduced and recommend to reduce the dose of chemotherapy and the administration of granulocyte colony-stimulating factor should be increased in older age group. ALL and AA are mainly diseases of young age group and AML seen in younger age group of Iraqi population, those three forms the majority of cases in this study.…”

mentioning

confidence: 99%

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

Naji¹,

SarKo

Atta

2022

Open Access Maced J Med Sci

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BACKGROUND: Febrile neutropenia occurs in more than 80% of patients with hematological malignances specially after chemotherapy cycles and an infectious source is identified in approximately 20–30%. Various bacterial, viral, and fungal pathogen contribute to the development of neutropenic fever and without prompt antibiotic therapy mortality rate can be as high as 70%. AIM: The objective of the study was to document the current sites of infection in patients with febrile neutropenia in hematological ward in Baghdad Teaching Hospital, the microorganisms and antibiotic susceptibly in culture positive cases and mortality rate in 1 week and 4 weeks after episode of fever. PATIENTS AND METHODS: One hundred cases of febrile neutropenia were evaluated in Hematological Ward of Baghdad Teaching Hospital from January 2019 to January 2020. Detailed history, physical examination, and laboratory investigations were conducted and statistical analysis of the results was done. RESULTS: One hundred cases of febrile neutropenia, mean age of presentation was 41.56 ± 10.5 years. Acute myeloid leukemia (36%) and acute lymphocytic leukemia (26%) were the most common underlying hematological disorder, followed by Aplastic Anemia, Non-Hodgkin Lymphoma, and Hodgkin Lymphoma. Temperature ranged from 38°C to 39°C with mean temperature of 38.4°C and most of the patient presented with short duration of fever, 57% had absolute neutrophil count below 150 cells/μL with mean duration of neutropenia was 14.01 days. Respiratory tract was the most common site of infection (52%) followed by urinary tract (18%) and in 16% had no obvious focus of infection. Thirty percent of cases were culture Gram-positive and Gram-negative microorganism which were more common 62.9% which were generally sensitive to Aminoglycosides while Gram-positive microorganism constituted 29.6% of isolated bacteria and were generally sensitive to vancomycin. No mortality documented 1 and 4 weeks after fever. CONCLUSION: We concluded that the most frequent sites of infection in patient with febrile neutropenia were respiratory tract followed by urinary tract infection, while 16% had undetermined source of infection. Thirty percent of patients had a positive blood culture with Escherichia coli being the most common infecting microorganism, Gram-negative microorganisms were more common than Gram-positive microorganism and fungal infection constituted about 6% of growth. Significant association was found between the fever and longer duration of neutropenia and the greater severity of neutropenia was observed. No mortality related to febrile neutropenia was documented.

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A Close Look at Neutropenia among Cancer Patients — Risk Factor and Management

Cited by 3 publications

References 42 publications

Comparison of CISNE and MASCC Score in Predicting Complications on Post Chemotherapy Febrile Neutropenia

Comparison of CISNE and MASCC Score in Predicting Complications on Post Chemotherapy Febrile Neutropenia

A sequential exploratory study to develop and validate neutropenic nursing care bundle for neutropenic patients admitted in a tertiary care hospital, Uttarakhand

Current Sites of Infections and Types of Microorganisms in Patient with Febrile Neutropenia in Hematological Wards – Single Center Study

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