Management of Febrile Neutropenia in Patients receiving Chemotherapy for Solid Tumors: A Retrospective Study of Twenty Cases from the Radiotherapy Centre, Accra, Ghana

Vanderpuye, Verna; Yarney, Joel; Beecham, K.

doi:10.4314/wajm.v29i5.68249

Cited by 7 publications

(8 citation statements)

References 28 publications

(35 reference statements)

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“…Mortality within 90 days of starting chemotherapy among cancer patients in the current study was found to be 12% and was similar to 11% that was reported by Kudere et al from the United States among cancer patients on therapy in 2006 and slightly higher than 8% which has currently being reported from South Africa [8,15]. Additionally, similar mortality was reported in the study done in West Africa 8 years ago which reported the mortality of 10% [16].…”

Section: Discussionsupporting

confidence: 90%

Mortality among cancer patients within 90 days of therapy in a tertiary hospital of Tanzania: is our pre therapy screening effective?

Changalucha¹,

Mushi

Kabangila

et al. 2019

Preprint

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Background A high mortality has been reported during the first ninety days of cancer therapy and is more pronounced in patients with febrile neutropenia. Bugando Medical Center, oncology department offers cancer diagnosis and treatment services to the population of lake-zone of Tanzania with limited data on the 90 days outcome. Here, we report the 90 days mortality and factors associated with it among cancer patients attending oncology department of the tertiary hospital in Tanzania. Methodology Enrolled participants underwent baseline physical examinations and functional status assessment using Karnofsky score. On each clinic visit, FBP was taken and patients were investigated for infections. Data were entered in Microsoft Excel and analyzed using STATA version 13. Results A total of 102 participants were enrolled. Their median age was 50 years [38-60]. The majority of study participants were females 76(75%) and 82(80.4%) had primary school education. The majority of patients had solid cancer 96(94.1%). A total of 12 (11.8%) patients died within 90 days of starting therapy. Having low hemoglobin level before starting cancer therapy (p=0.001), having Karnofsky score below 80% (p=0.001) and using 5-fluorouracil containing therapy (p=0.004) were found to be associated with mortality within 90 days of therapy among cancer patients. Conclusion About 10% of cancer patients die within 90 days of therapy. Anemic patients, with poor performance status and on 5-Fluorouracil regimen are more likely to die within 90 days of cancer therapy.

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Section: Discussionsupporting

confidence: 90%

Mortality among cancer patients within 90 days of therapy in a tertiary hospital of Tanzania: is our pre therapy screening effective?

Changalucha¹,

Mushi

Kabangila

et al. 2019

Preprint

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“…Furthermore, the mortality was significantly high compared to 7.2% reported by the International Agency for Research on Cancer from Sub-Saharan Africa in the global cancer statistics of 2012 [ 15 ]. Additionally, similar mortality was reported in the study done in West Africa 8 years ago which reported the mortality of 10% [ 16 ]. Low functional status due to cancer itself and the toxicity brought by the therapy collectively compromise the health of the patients and might lead to high mortality observed after therapy initiation in the current study.…”

Section: Discussionsupporting

confidence: 84%

Mortality among Cancer Patients within 90 Days of Therapy in a Tertiary Hospital, Tanzania: Is Our Pretherapy Screening Effective?

Changalucha

Mushi

Kabangila

et al. 2020

Journal of Cancer Epidemiology

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Background. A high mortality has been reported during the first ninety days of cancer therapy and is more pronounced in patients with febrile neutropenia. The Bugando Medical Center oncology department offers cancer diagnosis and treatment services to the population of the Lake Zone of Tanzania with limited data on the outcome within 90 days of therapy. Here, we report the 90-day mortality and factors associated with it among cancer patients attending the oncology department of the tertiary hospital in Tanzania. Methodology. Enrolled participants underwent baseline physical examinations, and their functional status was assessed using Karnofsky score. On each clinic visit, full blood picture was taken and patients were investigated for infections. Data were entered in the Microsoft Excel, cleaned and coded and then transferred to STATA version 13 for analysis. Results. A total of 102 participants were included in the final analysis. Their median age was 50 years (38-60). The majority of the study participants were females 76 (75%), and 82 (80.4%) had primary school education. The majority of the patients had solid cancer 96 (94.1%). A total of 12 (11.8%) patients died within 90 days of starting therapy. Low hemoglobin level at the start of cancer therapy, Karnofsky score below 80%, and using 5-fluorouracil-containing therapy were statistically significantly found to be associated with mortality within 90 days of therapy among cancer patients. Conclusion. One tenth of cancer patients at Bugando Medical Center do not survive within 90 days of therapy; the mortality is significantly high among anemic patients, with poor performance status, on 5-fluorouracil regimen, and diagnosed with head and neck cancer, necessitating close follow-up of these patients.

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“…15,[17][18][19] The median of the ANC (193 x 10 3 ) varies considerably between studies, being reported lower in some cases, as in the study of Düzenli (100 x 10 3 ), and greater in others, as in the Vanderpuye study (200 x 10 3 ). 18,20 Severe neutropenia (<200 x 10 3 ANC) was present in 19.3% events, lower than the study of Vathana et al, where it appeared in 44.4% laboratory findings. 21 Blood culture collection, although subpar according to current treatment guidelines, 8 is comparable with international and national studies, where it has varied from 9.4% to 26%.…”

Section: Discussionmentioning

confidence: 68%

Management of febrile neutropenia in pediatric cancer patients

Acosta¹

2019

JPNC

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Introduction: Febrile neutropenia (FN) is the most common complication that threatens the life of patients undergoing chemotherapy. It is considered an oncological emergency and its therapeutic decisions must be timely and accurate. Objective: To evaluate the therapeutic approach given to pediatric cancer patients with episodes of neutropenia and fever. Material and methods: Descriptive, observational, cross-sectional and retrospective study in children with acute lymphoblastic leukemia (ALL), acute myeloblastic leukemia (AML), Burkitt's lymphoma (BL) and lymphoblastic lymphoma (LL) who attended the hematology service from 2014 to 2018. Age, gender, underlying diagnosis, treatment phase, absolute neutrophil count, clinical manifestations, blood culture collection and results, initial antimicrobial therapy, treatment changes, complications, days of hospital stay and mortality were analyzed. Descriptive statistics was used, with measures of central tendency, percentages and frequencies with the SPSS v22 program. Results: We identified 104 episodes of FN in 70 patients with cancer. The mean age was 7 years and majority of patients were male (n=49, 70.0%). ALL was the most frequent underlying malignancy (n=59, 84.3%) and the highest amount of FN episodes occurred during the induction phase (n=74, 71.2%). Fever of unknown origin was observed in 29 (27.9%) episodes. Blood cultures were collected in 14 (13.5%) cases. The most commonly isolated microorganisms in blood culture were Gram-positive bacteria (n=10, 76.9%). β-lactams and aminoglycosides were the most common antibiotics used. Conclusions: Febrile neutropenia is a frequent complication in the pediatric population with hemato-oncological diseases in our hospital. The therapeutic approach that patients receive is adequate.

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Management of Febrile Neutropenia in Patients receiving Chemotherapy for Solid Tumors: A Retrospective Study of Twenty Cases from the Radiotherapy Centre, Accra, Ghana

Abstract: Gestion des neutropénies fébriles chez les patients

Cited by 7 publications

References 28 publications

Mortality among cancer patients within 90 days of therapy in a tertiary hospital of Tanzania: is our pre therapy screening effective?

Mortality among cancer patients within 90 days of therapy in a tertiary hospital of Tanzania: is our pre therapy screening effective?

Mortality among Cancer Patients within 90 Days of Therapy in a Tertiary Hospital, Tanzania: Is Our Pretherapy Screening Effective?

Management of febrile neutropenia in pediatric cancer patients

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