Retrospective epidemiological and clinical study of antineoplastic-induced febrile neutropenia in pediatric and juvenile patients / Estudo epidemiológico e clínico retrospectivo da ocorrência de neutropenia febril induzida por antineoplásicos em pacientes pediátricos e juvenis

Abstract

Several chemotherapy antineoplastic drugs are significant bone marrow suppressors that may cause neutropenia as side effect which, when febrile, is related to indirect signaling of a possible infectious process in evolution. The present study aimed to describe the clinical and socioeconomic profile of pediatric patients with febrile neutropenia. It is a retrospective, descriptive, observational and qualitative and quantitative study concerning the epidemiologic and clinical profile of oncologic pediatric patients receiving chemotherapy in the Community Hospital Dr. Jeser Amarante Faria who presented febrile neutropenia during January 1st, 2019, to December 31st, 2020. Sociodemographic and clinical data were collected from electronic medical records in the computerized system of the institution (TASY®). A total of 147 patients receiving chemotherapy protocols were found, 51 of those met inclusion criteria and totalized 79 hospitalizations due to febrile neutropenia. Diagnosed tumors undertook slightly more male than female patients, of predominantly white ethnicity and non-literate, mostly from Joinville, SC, Brazil. The most diagnosed tumor was acute lymphocytic leukemia, and the most febrile neutropenia antineoplastic drugs were cytarabine, etoposide cytarabine, etoposide and cyclophosphamide. More than half (54%) hospitalizations due to febrile neutropenia were severe, demanding use of filgrastim in 38% of them. Average hospitalization time was 15 ± 20 days, and hospital discharge being the main outcome (91%) of the hospitalizations. Microorganism isolation took place in 24% of hospitalizations, reaching Gram-positive cocci and Gram-negative bacilli mainly. Cefepime, vancomycin and cotrimoxazole were introduced in, respectively, 82%, 42% and 88% of the hospitalizations and 21 patients were concomitantly receiving psychotropics and antihypertensives. The clinical and epidemiological profile contributes to strategic planning concerning public actions towards specialized assistance to this population and their relatives, aiming increased survival rate, quality of life and a better prognostic for the patients.