Characterization of oncological-hematological patients hospitalized with febrile neutropenia after chemotherapy in a university hospital
DOI:
https://doi.org/10.5902/2236583474075Keywords:
Febrile neutropenia, Diagnosis, Chemotherapy-induced febrile neutropeniaAbstract
Introduction: Febrile neutropenia (FN) is a frequent and important complication in patients undergoing chemotherapy, potentially fatal, considered a clinical emergency, in which the immediate administration of wide spectrum antibiotics considerably reduces mortality. Studies with data available in the literature involving the characterization of hospitalized patients with post chemotherapy FN are scarce. Objective: to characterize oncological-hematological patients hospitalized with post chemotherapy febrile neutropenia in a tertiary hospital. It was an observational, cross-sectional and retrospective study, which included data from all patients hospitalized in the oncology sector of the aforementioned university hospital, during the period of this study, who had a diagnosis of leukemia, lymphoma, multiple myeloma or myeloproliferative syndromes, over 18 years old and undergoing chemotherapy treatment. Results: there was a predominance of male patients (55.77%), mean age of 40,60 years, and most were married (57.70%). In terms of profession, most of them did not fill in the medical record (42.31%). Regarding education, the majority had incomplete elementary school (42.01%), and only one had completed higher education, but without detailing the course. The majority had no comorbidities (42.31%), and acute myelocytic leukemia (38.46%) was the most frequent cancer. Two blood cultures were performed for most patients (75.00%) and gram positive were the agents with the highest frequency of isolation, 98.08% received empirical antibiotic therapy with at least one drug, and most did not receive antifungal empirical (73.08%). The number of survivors (51.92%) in the period of this study exceeded the number of deaths (48.08%). Final considerations: Immediate recognition of the patient with FN according to the risk and the adequate treatment with immediate initiation of empirical drug therapy define the patient’s survival.
Downloads
References
Klastersky J, de Naurois J, Rolston K, Rapoport B, Maschmeyer G, Aapro M, Herrstedt J; ESMO Guidelines Committee. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2016 Sep;27(suppl 5):v111-v118. doi: 10.1093/annonc/mdw325. PMID: 27664247.
Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Raad II, et al, Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2011;52:56- 93. doi: 10.1093/cid/cir073.
LONG, Dan L. et al. Medicina interna de Harrison. 18. ed. Porto Alegre, RS: AMGH Ed., 2013. 2 v.
Ferreira, JN et al. Manejo da neutropenia febril em pacientes adultos oncológicos: revisão integrativa da literatura. (Rev Bras Enferm , nov-dez;70(6):1371-8, 2017.
Garcia, RCL, et al. NEUTROPENIA FEBRIL: ABORDAGEM DIAGNÓSTICA E TERAPÊUTICAACTA MED. (Porto Alegre) 39(2): 269-279, 2018.
Bergstrom C, Nagalla S, Gupta A. Management of patients with febrile neutropenia a teachable moment. JAMA Intern Med. 2018;178(4):558–9.
Taplitz RA, Kennedy EB, Flowers CR: Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update summary. J Oncol Pract 14:250-255, 2018.
Oliveira, MD de, Souza, RF, Canuto, DKS, Machado, AM, & Machado, AR da SR (2020). Avaliação do perfil epidemiológico das neoplasias onco-hematológicas de pacientes atendidos pelo instituto de câncer de três lagoas, no período de 2014 a 2018 Brazilian Journal of Development , 6 (2), 7301–7314. https://doi.org/10.34117/bjdv6n2-144
R. Fonseca M, Jorge I, Rodrigues G. A Propósito de “Sete Anos de Neutropenias Febris num Serviço de Medicina Interna”. RPMI [Internet]. 20 de Setembro de 2019 [citado 3 de Fevereiro de 2023];26(3):247-8. Disponível em: https://revista.spmi.pt/index.php/rpmi/article/view/419
Pinho M, Rodrigues C, Guedes L, Costa E, Gonçalves E, Sete Anos de Neutropenias Febris num Serviço de Medicina Interna. Rev Soc Port Med Interna. 2019; 26: 97-105.
Talcott JA, Finberg R, Mayer R, Goldman L. The medical course of cancer patients with fever and neutropenia. Clinical identification of a low-risk subgroup at presentation. Arch Intern Med. 1988;148(12):2561-8.
Schimpff S, Satterlee W, Young VM, Serpick A. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med. 1971;284(19):1061-5.
Bellesso M., Figueiredo, S,C.D. Costa e Chamone, D.A.F. et al. Triagem para o tratamento ambulatorial da neutropenia febril. Rev Bras Hematol Hemoter. Vol. 32(5):402-408. DOI: 10.1590/S1516-84842010000500014.
Marcelo Bellesso, Silvia Figueiredo Costa e Dalton Alencar Fischer Chamone et al. Triagem para o tratamento ambulatorial da neutropenia febril. Rev Bras Hematol Hemoter. Vol. 32(5):402-408. DOI: 10.1590/S1516-84842010000500014.
Naurois J, Klastersky J, Rolston K, Rapoport B, Maschmeyer G, Aapro M, et al. Management of febrile neutropenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2016; 27:111-8. doi: 10.1093/annonc/mdw325.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Christine Horner, Andreas Horner

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
A Declaração de Direito Autoral e os itens a serem observados podem ser visualizados no seguinte link: http://cascavel.ufsm.br/revistas/ojs-2.2.2/index.php/seculoxxi/information/sampleCopyrightWording

