retrospective analysis, the authors evaluated the incidence of neutropenic fever, fever (41 episodes among 40 patients). The incidence of neutropenic fever did not Anderson Cancer Center, Houston, Texas.increase until the absolute neutrophil count (ANC) had decreased to less than 500/ mL, and then fever incidence had a linear relationship with decreasing ANC (linear trend, P õ 0.01). A source of infection was documented in 59% of the neutropenic fever episodes. The incidence of infection did not increase significantly until the ANC had decreased to less than 250/mL (P õ 0.01). The risk of neutropenic fever and infection was also significantly higher when patients had poor performance status or were undergoing the initial courses of chemotherapy. Patients with bone marrow metastases also had a higher frequency of fever, infection, and death, but these differences were not statistically significant.
CONCLUSIONS.For patients with metastatic breast carcinoma receiving salvage chemotherapy, the risk of fever increases with decreasing ANC, but the risk of infection does not increase significantly until ANC decreases to less than 250/ mL. ship between infections and neutropenia was first described about 30 years ago in patients with acute leukemia receiving chemotherapy. 2Received July 29, 1996; revision received November 20, 1996; accepted November 20, 1996.Since then, considerable progress has been made in the management ᭧ 1997 American Cancer Society