Febrile neutropenia in childhood leukemia: Manado experience 1997 - 2006

Abstract

Background Febrile neutropenia (FNP) is a common complicationof therapy among children with cancer. It is one of the causes ofsignificant morbidity and mortality in children and young adultstreated for cancer. With aggressive management of FNP, theoutcome of episodes in children has improved dramatically.Objective To determine factors associated with FNP, to assess how varied the current management, and to evaluate the outcome of FNP in childhood leukemia in Manado over the last 10 years.Methods Data from medical records was collected retrospectivelyfrom January 1997 to December 2006. Variables studied were: age, sex, nutritional status, sosio-economic status, type of leukemia, degree of fever, ANC at fever, phase of chemotherapy, antibiotic used, episodes ofFNP and the outcome of patients.Results Twenty of ninety one patients were studied. The mortality rate was crucial i.e., 11 of20, it was higher in boys than that in girls. Most children have severe to very severe neutropenia and more than half died (7 /13). Seven out of 12 malnourished patients died. Sixteen children are suffered from acute lymphoblastic leukemia (ALL). The outcome of high risk (HR) patients was worse than that of standard risk (SR). FNP occurred along the phase of chemotherapy. None of the factors studied showed significant difference. The choice of antibiotics is varied.Conclusion The outcome of FNP in our institution is grave.There is a need to evaluate application and compliance to thestandard guidelines.

Kadar Procalcitonin pada Anak dengan Demam Neutropenia

“…Pada kelompok dengan biakan bakteri yang positif, tidak ada perbedaan yang bermakna antara D emam neutropenia merupakan komplikasi yang umum terjadi pada anak pasien keganasan dan merupakan salah satu penyebab morbiditas dan mortalitas yang tinggi. [1][2][3][4][5] Data European Organization for Research and Treatment of Cancer (EORTC) tahun 1985-2000 mortalitas demam neutropenia 8,5%. 6 Studi di Singapura didapatkan mortalitas 8,8%, 7 sedangkan 48% angka kejadian demam neutropenia terjadi di Rumah Sakit Dr. Hasan Sadikin, Bandung.…”

“…6 Studi di Singapura didapatkan mortalitas 8,8%, 7 sedangkan 48% angka kejadian demam neutropenia terjadi di Rumah Sakit Dr. Hasan Sadikin, Bandung. 4 Sekitar 60% demam neutropenia disebabkan oleh bakteri dengan ataupun tanpa bakteremia. Progresivitas infeksi pada pasien neutropenia dapat berlangsung sa ngat cepat dan keadaan infeksi bakteri pada awal penyakit sulit dibedakan dengan keadaan noninfeksi.…”