LÖSEMİ DIŞI ÇOCUKLUK ÇAĞI KANSERLERİNDE FEBRİL NÖTROPENİ ATAKLARININ DEĞERLENDİRİLMESİ

Öz

Amaç: Çocukluk çağı solid tümörlerinde febril nötropeni ataklarının klinik seyir ve özelliklerini değerlendirerek uygun bir takip ve tedavi yaklaşımı oluşturmaktır. Yöntemler: Çalışmamızda, Kasım 2019- Nisan 2020 tarihleri arasında kliniğimizde takip edilen lösemi dışı çocukluk çağı kanseri tanılı 18 yaş altı 30 hastanın 60 febril nötropeni atağı, tedavileri, tedavi yanıtları ve ailelerin sosyo-ekonomik düzeyleri incelendi. Bulgular: En sık tanılar; nöroblastom (%31,7), Wilms tümörü (%16,7) ve non-Hodgkin lenfoma (%18,3) idi. Ataklar sırasında alınan kültürlerin 15’inde (%25) üreme saptandı. 10 atakta (%16,6) bakteriyemi mevcuttu. Febril atakların %76,7’sinin (46 atak) kemoterapi uygulamasından sonraki ilk 7 gün içinde meydana geldiği saptandı. En fazla atak görülen günler, kemoterapi uygulamasından sonraki 5. ve 6. (%33,4) günlerdi. Başvuru sırasında ateşi daha yüksek olan ve beyaz küre sayısı düşük hastaların ilerleyen süreçte tedavilerinde değişiklik yapılma ihtiyacının diğer hastalara göre daha yüksek olduğu saptandı. Üç hasta (%5) atak sırasında kaybedildi. Aylık geliri 4000 TL üzerinde ve eğitim düzeyi daha düşük olan ailelerin, hastaneye ulaşma sürelerinin anlamlı olarak daha kısa olduğu görüldü. Sonuç: Febril nötropeni atakları sırasında ailelerin sosyo-kültürel ve ekonomi düzeyleri, iyileşme sürecini doğrudan etkileyebilmektedir.

Anahtar Kelimeler

• febril nötropeni
• ampirik tedavi
• kemoterapi
• çocuk onkoloji

EVALUATION OF FEBRILE NEUTROPENIA ATTACKS IN PATIENTS WITH NON-LEUKEMIA CHILDHOOD CANCER

Abstract

Objective: To establish an appropriate follow-up and treatment approach by evaluating the clinical course and characteristics of febrile neutropenia attacks in childhood solid tumors. Methods: In our study; 60 febrile neutropenia attacks, treatments they received, treatment responses and socio-economic levels of families under the age of eighteen years of 30 patients diagnosed with non-leukemia childhood cancer between November 2019 and April 2020 were examined. Results: The most common diagnoses were neuroblastoma (31.7%), Wilms tumor (16.7%) and non-Hodgkin lymphoma (18.3%). Bacteremia was present in 10 attacks (16.6%). It was found that 76.7% (46 attacks) of febrile attacks occurred within the first 7 days after chemotherapy cure. Most attacks occured on the 5th and 6th days (33.4%). It was found that patients with higher fever temperatures and low white blood cell counts during the hospital admission had a higher need to make changes in their treatment in the future. Three patients (5%) died during febrile neutropenia attacks. It was determined that the families who have monthly income over 4000 TL and lower education level have a significantly shorter reaching time to hospital than other families. Conclusion: During episodes of febrile neutropenia, the socio-cultural and economic levels of families can directly affect the recovery process.

Keywords

• Febrile neutropenia
• Empirical therapy
• Chemotherapy
• Pediatric Oncology

Kaynakça

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