Risk factors for febrile neutropenic attacks in patients who were given chemotherapy treatment for hematological malignancies
Journal Title: Ege Tıp Dergisi - Year 2015, Vol 54, Issue 4
Abstract
Aim: Febrile neutropenic attacks are an important problem during and after chemotherapy. We retrospectively reviewed the records of patients who were administered chemotherapy treatment to identify the risk factors for febrile neutropenic attacks. Materials and Methods: A total of 261 inpatient periods that included 154 patients (92 male and 62 female) between 2004 and 2006 were analyzed retrospectively. The median age was 49.5 (range, 17-80) years. Patients' clinical and demographic data were collected. We analyzed the relationship between febrile neutropenic attacks and clinical variables (diagnosis, age, sex, chemotherapy regimen, stem cell transplantation, the length of the neutropenic period, the presence of central venous catheter, and granulocyte colony stimulating factor [G-CSF] use) by a stepwise logistic regression model. Results: Febrile neutropenic attacks were detected in 201 (77%) inpatient periods. A diagnosis of acute leukemia (OR: 3.36, 95% CI: 1.16-9.78, p=0.02), stem cell transplantation (OR: 8.77, 95% CI: 2.41-31.821, p=0.001), G-CSF use (OR: 8.46, 95% CI: 3.28-22.04, p=0.000) and length of the neutropenic period ≥ 10 days (OR: 4.01, 95% CI: 0.83-19.24, p=0.001) were risk factors for febrile neutropenic attacks. Conclusion: Acute leukemia, stem cell transplantation, length of the neutropenic period ≥ 10 days and treatment with G-CSF were the most important risk factors for febrile neutropenic attacks. The result that G-CSF was a risk factor for febrile neutropenia was attributed to the fever-inducing effect of this drug. The use of G-CSF should be questioned in neutropenic patients with fever, especially in those without signs and symptoms of infection.
Authors and Affiliations
Nur Soyer, Fergun Yılmaz, Şöhret Aydemir, Murat TOMBULOĞLU, Ahmet Dirican, Seçkin Çağırgan, Ayhan Dönmez
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