Composite Adverse Event Outcome in Pediatric Cancer Patients with Prolonged Febrile Neutropenia

Year 2016, Volume: 6 Issue: 2 - J Microbiol Infect Dis 2016; 06(02) June Issue, 69 - 73, 01.06.2016

Muhammad Matloob

https://doi.org/10.5799/jmid.vi.328804

Abstract

Objective: Pediatric cancer patients with prolonged febrile neutropenia have increased risk for severe, recurrent or new
bacterial and fungal infection. The aim of this study was to identify the risk factors associated with adverse outcomes
in this group.
Methods: We retrospective analyzed the clinical data of 135 hospitalizations of pediatric cancer patients with prolonged
febrile neutropenia from a tertiary health care center of Pakistan.
Results: The mean age of the study population was 7.3±4.1 years. There were 98 (72.6%) males and 37 (27.4%) females.
Acute leukemia with 88 patients (65.2%) was the most common diagnosis followed by lymphomas 19 patients (14.1%)
and solid tumors. Cause of febrile neutropenia was identified in only 58 (43.0%) patients, out of them blood stream
infections were found in 22 cases (16.3%), pneumonia in 15 (11.1%), fungal infection in 13 (9.6%), infectious diarrheas
in 5 (3.7%) and urinary tract infection (UTI) in 3 (2.2%) of cases. The composite adverse event outcome was observed
in 28 (20.7%) of patients, with in-hospital mortality occurring in 7 (5.2%), Pediatric intensive care unit (PICU) admission
occurring in 12 (8.9%) and inotropic support was required in 9 (6.7%). On logistic regression analysis AML (Adjusted
odds ratio (AOR), 7.6; P<0.001), neutropenia <50/mm3
(AOR, 10.8; p<0.001), platelets count <50,000/mm3
(AOR, 5.2;
p<0.001), BSI (AOR, 2.3; p 0.05) and fungal infection (AOR, 4.3; p<0.001) were found as independent risk factors for
composite adverse event outcome in pediatric cancer patients with prolonged febrile neutropenia.
Conclusions: AML, severe myelosuppression, blood stream infections and fungal infection were identifiable risk factors
associated with development of adverse event outcome in pediatric cancer patients with prolonged febrile neutropenia.
J Microbiol Infect Dis 2016;6(2): 69-73   

Keywords

Febrile neutropenia, pediatric, oncology, adverse outcome

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