Assessment of Chemotherapy-Induced Febrile Neutropenia in Cancer Patients

Abstract

Purpose: Chemotherapy-induced febrile neutropenia (CIFN) is an adverse drug reaction which needs medical attention. The treatment options for the CIFN are mandatory to improve treatment outcomes and quality of life. Methods: A prospective observational study was conducted in the in-patients and out-patients of oncology department who received chemotherapy from October 2016 to March 2017. The information such as demographics (age, gender, and comorbidities), complaints on admission, hematological investigations (neutrophil counts, platelet counts, hemoglobin levels, erythrocyte sedimentation rate, and white blood cells), type of tumor, stage of cancer, prophylaxis, cycle of antineoplastic chemotherapy that cause febrile neutropenia, treatment history, and outcome data were obtained from the patient's clinical record. The Multinational Association for Supportive Care in Cancer score and Absolute Neutrophil Count grading was used to predict the patient's risk of developing CIFN. Results: Out of 200 patients, 19 patients developed 22 episodes of CIFN. The overall occurrence of CIFN during the study was 9.5%. The higher incidence of CIFN has been observed among male gender (57.89%), stage III patients (42.10%), solid tumor (73.68%), and double chemotherapy regimen (59.1%). The higher incidence of CIFN was developed in I cycle (36.36%) followed by II cycle (22.72%) and VI cycle (18.18%). Conclusions: The incidence of CIFN during the study was 9.5%. In the 19 chemotherapy-induced FN patients, there has no significant effect of prophylaxis to prevent the febrile neutropenia.

Chemotherapy-induced neutropenia among breast Cancer patients in a tertiary care hospital: Risk and consequences

“…16 Among the disease specific risk factors, tumour stage IIIa is associated with increased risk of CIN as compared to other stages. Philip et al 17 study also reported higher incidence of CIN in stage III (42.04%) and found advanced tumour stage as a possible risk factor for neutropenia.…”

A prospective, real-world, multinational study of febrile neutropenia (FN) occurrence in oncology patients receiving chemotherapy with intermediate risk of FN: a MASCC Neutropenia, Infection, and Myelosuppression Study Group initiative

“…In the present analysis, the rate of episodes of FN in each cycle varied; 5% were encountered in cycle 1, followed by 3% and < 1% in cycles 2 and 6, respectively. A similar pattern, but a higher rate of FN, was noted in an observational study; of 19 patients, the first (36.36%) and second (22.72%) cycles of chemotherapy exhibited a higher incidence of FN cases than other chemotherapy cycles [20]. Culakova et al reported 9.7% incidence of FN in cycle 1, followed by 5.7% and 3.8% in cycles 2 and 3, respectively [21].…”

Chemotherapy Induced Neutropenia, Febrile-Neutropenia and Determinants Among Solid Cancer Patients Attending Oncology Unit of a Tertiary Care Teaching Hospital in Ethiopia

“…But research conducted by Weycker et al and Philip et al showed different results than the present study. 21 , 22 According to Weycker et al’s research, the overall risk of FN during any myelosuppressive chemotherapy regimen course was 16.8%, which is almost 3 times lower compared to our study finding of 50% FN. Risk of FN was 8.1% in cycle 1, 4.9% in cycle 2, and 3.8% in subsequent cycles.…”

“…21 Similarly, the research done by Philip et al showed that the incidence of chemotherapy induced febrile neutropenia (CIFN) in each cycle varied, 36.63% was encountered in cycle 1 followed by 22.72% and 18.18% in cycle 2 and cycle 6, respectively. 22 Moreover, the research conducted by Salako et al showed that the incidence of neutropenia decreased with increasing chemotherapy courses, with a rate of 14.2% and 4.9% after the first and last course, respectively. 14 While in our case it was incremental starting from 8.7% in the 1st cycle to 20.7% in the 5th cycle.…”