Using Vital Sign Flow Sheets Can Help to Identify Neoplastic Fever and Other Possible Causes in Oncology Patients: A Retrospective Observational Study

Liaw, Chuang-Chi; Huang, Jian-Jia; Chen, Jen‐Shi; Chang, Jeng-Shou; Chang, Hsien‐Kun; Liau, Chi‐Ting

doi:10.1016/j.jpainsymman.2010.01.015

Cited by 15 publications

(25 citation statements)

References 25 publications

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“…Furthermore, ATRs and FNHTRs tended to occur at the same time after starting a transfusion. In patients with haematologic or malignant disease receiving transfusions, comprising the majority of patients in this study, it is usually important to distinguish FNHTRs from other causes of fever, such as neoplastic fever and febrile neutropenia . In comparison with neoplastic fever in adults and febrile neutropenia in children, the peak temperature in febrile patients was similar among FNHTRs and other causes of fever.…”

Section: Discussionmentioning

confidence: 88%

“…Therefore, determining the cause of fever in the actual clinical setting may be difficult. However, neoplastic fever is associated with a once daily spike pattern , while febrile neutropenia is sometimes characterized by persistent fever for several days . Previous guidelines have also outlined that bacterial contamination and haemolytic reactions should be suspected if a patient develops a sustained fever or a moderately severe fever (temperature ≥39°C or an increase of ≥2°C from baseline and/or systemic symptoms, such as chills, rigour, myalgia, nausea or vomiting) .…”

Section: Discussionmentioning

confidence: 99%

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Analysis of clinical presentations of allergic transfusion reactions and febrile non‐haemolytic transfusion reactions in paediatric patients

et al. 2019

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Background and objectives Like adults, children can have allergic transfusion reactions (ATRs) and febrile non-haemolytic transfusion reactions (FNHTRs). But published information about the incidence of paediatric ATR and FNHTR is scarce.Materials and methods This retrospective study was conducted from April 2002 to June 2018 on children who had ATRs and/or FNHTRs to platelet (PLT), red blood cell (RBC) or washed PLT/RBC concentrate transfusions. We analysed ATR/ FNHTR clinical presentations, such as severity, time of occurrence and other features when they occurred.Results During the study, 2742 children received 23 444 bags of PLT and RBC concentrate (including washed products). ATRs occurred in 100 cases (3Á6% of total patients), caused by 201 products (0Á9% of total products). In contrast, 28 patients (1Á0% of total patients) had 42 FNHTRs caused by 42 products (0Á2% of total products). Upon analysis of cases with detailed clinical information, the median onset time for ATRs and FNHTRs was 2Á0 h after the start of transfusion. Of the 40% of ATRs that necessitated the discontinuation of blood transfusions, 10% escalated to anaphylaxis. Compared with minor ATRs, anaphylaxis tended to develop quickly. Moreover, 96% of patients with FNHTRs had a fever less than 39°C. There were no associations between blood product types and numbers or occurrence patterns of these reactions. ConclusionThe occurrence of ATRs and FNHTRs in children was variable, although there are common features such as severity and time of occurrence.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Analysis of clinical presentations of allergic transfusion reactions and febrile non‐haemolytic transfusion reactions in paediatric patients

et al. 2019

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“…80 Although the incidence of fever in pediatric FNHTR is not yet fully understood, in pediatric hematology and oncology practices, FNHTR require differential diagnosis from infectious diseases such as febrile neutropenia or neoplastic fever. 81,82 In one study, severity of ATR and FNHTR did not change depending on the occurrence time of ATR or FNHTR, and there was no difference in severity depending on the causative blood products. 27 It may not therefore be easy to predict the severity of ATR and FNHTR based only the clinical situation in which actual blood transfusions are performed.…”

Section: Analysis Of the Severity Of Tars (Focused On Atr / Fnhtr) Inmentioning

confidence: 95%

Preventing adverse reactions in pediatric transfusions using washed platelet concentrate

Yanagisawa

2021

Pediatrics International

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Blood transfusion is an important form of supportive care in children; however, transfusion-associated adverse reactions (TARs) are a problem. As with adults, allergic transfusion reactions (ATRs) and febrile non-hemolytic transfusion reactions (FNHTRs) are major TARs, and the frequency of ATRs caused by platelet concentrate (PC) tends to be particularly high. The plasma component of the blood product is thought to be a major factor in the onset of TARs such as ATR and FNHTR. By contrast, in children, age, underlying disease, and number of blood transfusions may be relevant patient-related factors. Although acetaminophen or diphenhydramine may be used prophylactically to prevent TARs, there is no clear evidence of their effectiveness. Volume-reduced PC is used to prevent TARs; however, it may be difficult to maintain the quality of platelets. Plasma-replaced PC stored with platelet additive solution raises the concern that TARs cannot be completely prevented by residual plasma. Washed PC removes most of the plasma, so it can effectively prevent ATR and FNHTR. The recent development of platelet additive solution [M-sol, bicarbonate Ringer's solution supplemented with acid-citrate-dextrose formula A (BRS-A)] in Japan has enabled the maintenance of the quality of platelets for long periods. The clinical use of washed PC in Japan has therefore progressed. Washed PC with M-sol or BRS-A for pediatric patients can effectively prevent TARs without diminishing the transfusion effect. The supply of washed PC has begun from the Japanese Red Cross Society, and it has become possible to use washed PC at all medical institutions in Japan.

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“…These included thromboembolism complications such as PVOS, cerebral thrombosis and cachexia, and neoplastic fever. Enoxaparin (Sanofi-Aventis) and dexamethasone were administered to treat thromboembolism complications, while progesterone agents and naproxen were administered for cancer cachexia and neoplastic fever, respectively (3,4,8,9). Analysis of survival time for more than two years.…”

Section: Methodsmentioning

confidence: 99%

“…Targeting these inflammatory responses may improve patient outcomes (34). Clinicians use dexamethasone and low molecular weight heparin for PVOS and cerebral thrombosis, progesterone agents for cancer cachexia, and naproxen for neoplastic fever (3,4,8,9). These therapies all suppress cytokine production.…”

Section: Utility Of Healing Process and Fibrosis Formationmentioning

confidence: 99%

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

Liaw

Liao

Tsui

et al. 2019

In Vivo

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Background/Aim: Urothelial carcinoma is a chemo-sensitive cancer. We investigated the contributory factors to survival benefit of metastatic urothelial carcinoma (MUC) patients receiving continuous maintenance chemotherapy. Patients and Methods: Inclusion criteria were: i) pathology-confirmed urothelial carcinoma, ii) metastatic lesions identified mainly on pre-therapy computed tomography (CT) scans, and iii) inpatient-administered chemotherapy of at least three cycles. Chemotherapy regimens included 5-fluorouracil, leucovorin, cisplatin, and gemcitabine. Results: A total of 139 cases were enrolled in this study. The overall objective response rate was 60% and the median survival time was 17 months. Eight-two (59%) patients had inflammation-related symptoms following the course of chemotherapy. Fifty-five (41%) patients survived more than two years. All patients exhibited various fibrosis formations. No patient experienced unfavorable metastatic conditions. Inflammation-related symptoms remained in 28 (51%) patients. We found that surgery, invasive procedures, and infection likely led to a rapid tumor progression. Conclusion: Continuous maintenance chemotherapy targeting chemo-sensitive tumors, administered at metronomic intervals and focus on tumor microenvironment, can increase MUC survival benefits.

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Using Vital Sign Flow Sheets Can Help to Identify Neoplastic Fever and Other Possible Causes in Oncology Patients: A Retrospective Observational Study

Abstract: We conclude that the NF pattern is characterized by intermittent fever without an obvious increase in baseline pulse rate except during febrile periods. Knowing NF patterns from vital sign flow sheets can help identify NF and other possible causes of fever in oncology patients.

Cited by 15 publications

References 25 publications

Analysis of clinical presentations of allergic transfusion reactions and febrile non‐haemolytic transfusion reactions in paediatric patients

Analysis of clinical presentations of allergic transfusion reactions and febrile non‐haemolytic transfusion reactions in paediatric patients

Preventing adverse reactions in pediatric transfusions using washed platelet concentrate

Survival Benefit for Patients With Metastatic Urothelial Carcinoma Receiving Continuous Maintenance Chemotherapy

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