Clinical Outcome of Febrile Neutropenia and Associated Factors Among Adult Patients with Cancer Treated at Ethiopian Oncology Centers: A Retrospective Observational Study

de Castro CJ, Gascón-Vilaplana P, Casas-Fernández-de Tejerina AM, et al. Epidemiology and characteristics of febrile neutropenia in oncology patients from Spanish tertiary care hospitals: PINNACLE study. Mol Clin Oncol. 2015;3(3):725–9.

Google Scholar 

Tralongo AC, Antonuzzo A, Pronzato P, et al. Management of chemotherapy-induced neutropenia in patients with cancer: 2019 guidelines of the Italian Medical Oncology Association (AIOM). Tumori J. 2020;106(4):273–80.

Google Scholar 

Klastersky J, De Naurois J, Rolston K, et al. Management of febrile neutropaenia: ESMO clinical practice guidelines. Ann Oncol. 2016;27:v111–8.

PubMed  Google Scholar 

Taplitz RA, Kennedy EB, Bow EJ, et al. 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. J Clin Oncol. 2018;36(14):1443–53.

PubMed  Google Scholar 

Lyman GH, Abella E, Pettengell R. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: a systematic review. Crit Rev Oncol Hematol. 2014;90(3):190–9.

PubMed  Google Scholar 

Flowers CR, Seidenfeld J, Bow EJ, et al. Antimicrobial prophylaxis and outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2013;31(6):794–810.

PubMed  Google Scholar 

Freifeld AG, Bow EJ, Sepkowitz KA, 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(4):e56–93.

PubMed  Google Scholar 

Arega B, Woldeamanuel Y, Adane K, Sherif AA, Asrat D. Microbial spectrum and drug-resistance profile of isolates causing bloodstream infections in febrile cancer patients at a referral hospital in Addis Ababa, Ethiopia. Infect Drug Resist. 2018;11:1511–9.

Carmona-Bayonas A, Jimenez-Fonseca P, de Castro EM, et al. SEOM clinical practice guideline: management and prevention of febrile neutropenia in adults with solid tumors (2018). Clin Transl Oncol. 2019;21:75–86.

PubMed  Google Scholar 

Kasi PM, Grothey A. Chemotherapy-induced neutropenia as a prognostic and predictive marker of outcomes in solid-tumor patients. Drugs. 2018;78:737–45.

PubMed  Google Scholar 

Tai E, Guy GP, Dunbar A, Richardson LC. Cost of cancer-related neutropenia or fever hospitalizations, United States, 2012. J Oncol Pract. 2017;13(6):e552–61.

PubMed  PubMed Central  Google Scholar 

Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106(10):2258–66.

PubMed  Google Scholar 

Zhang Y, Zheng Y, Dong F, et al. Epidemiology of febrile neutropenia episodes with gram-negative bacteria infection in patients who have undergone chemotherapy for hematologic malignancies: a retrospective study of 10 years’ data from a single center. Infect Drug Resist. 2020;13:903–10.

Ahn S, Lee Y-S, Chun Y-H, et al. Predictive factors of poor prognosis in cancer patients with chemotherapy-induced febrile neutropenia. Support Care Cancer. 2011;19:1151–8.

PubMed  Google Scholar 

Lalami Y, Klastersky J. Impact of chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) on cancer treatment outcomes: an overview about well-established and recently emerging clinical data. Crit Rev Oncol Hematol. 2017;120:163–79.

PubMed  Google Scholar 

Lynn JJ, Chen KF, Weng YM, Chiu TF. Risk factors associated with complications in patients with chemotherapy-induced febrile neutropenia in emergency department. Hematol Oncol. 2013;31(4):189–96.

PubMed  Google Scholar 

Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, et al. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study. J Clin Oncol. 2015;33(5):465–71.

PubMed  Google Scholar 

Pettengell R, Schwenkglenks M, Leonard R, et al. Neutropenia occurrence and predictors of reduced chemotherapy delivery: results from the INC-EU prospective observational European neutropenia study. Support Care Cancer. 2008;16:1299–309.

PubMed  Google Scholar 

Lyman GH, Michels SL, Reynolds MW, Barron R, Tomic KS, Yu J. Risk of mortality in patients with cancer who experience febrile neutropenia. Cancer. 2010;116(23):5555–63.

PubMed  Google Scholar 

Baden LR, Swaminathan S, Angarone M, et al. Prevention and treatment of cancer-related infections, version 2.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2016;14(7):882–913.

Google Scholar 

Girma T. Assessment of the management of neutropenic fever in adult patients with hematologic malignancies at Tikur Anbessa Specialized Hospital. Addis Ababa University; 2017.

Agegnew Wondm S, Dagnew EM, Tadesse Abegaz S, Kiflu M, Kebede B. Burden, risk factors, and management of neutropenic fever among solid cancer patients in Ethiopia. SAGE Open Med. 2022;10:20503121221098236.

PubMed  PubMed Central  Google Scholar 

Deressa BT, Cihoric N, Badra EV, Tsikkinis A, Rauch D. Breast cancer care in northern Ethiopia—cross-sectional analysis. BMC Cancer. 2019;19:1–6.

Google Scholar 

Azage M, Zewudie S, Goedert MH, Hagos EG. Epidemiological characteristics of cancer patients attending at Felege Hiwot Referral Hospital, Northwest Ethiopia. Int J Environ Res Public Health. 2023;20(6):5218.

PubMed  PubMed Central  Google Scholar 

Shmuely H, Monely L, Shvidel L. All-cause mortality and its predictors in haemato-oncology patients with febrile neutropenia. J Clin Med. 2023;12(17):5635.

PubMed  PubMed Central  Google Scholar 

Klastersky J, Paesmans M, Rubenstein EB, et al. The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000;18(16):3038–51.

PubMed  Google Scholar 

Günalp M, Koyunoğlu M, Gürler S, et al. Independent factors for prediction of poor outcomes in patients with febrile neutropenia. Med Sci Monit. 2014;20:1826.

PubMed  PubMed Central  Google Scholar 

Peyrony O, Gerlier C, Barla I, Ellouze S, Legay L, Azoulay E, et al. Antibiotic prescribing and outcomes in cancer patients with febrile neutropenia in the emergency department. PLoS ONE. 2020;15(2): e0229828.

PubMed  PubMed Central  Google Scholar 

Hatamabadi H, Dolatabadi AA, Akhavan A, Safari S. Clinical characteristics and associated factors of mortality in febrile neutropenia patients; a cross sectional study. Arch Acad Emerg Med. 2019;7(1):39.

Health UDo, Services H. Common terminology criteria for adverse events (CTCAE). 2017.

Ray-Coquard I, Borg C, Bachelot T, et al. Baseline and early lymphopenia predict for the risk of febrile neutropenia after chemotherapy. Br J Cancer. 2003;88(2):181–6.

PubMed  PubMed Central  Google Scholar 

World Health Organization. A healthy lifestyle-WHO recommendations. Erişim tarihi. 2010;1.

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.

PubMed  Google Scholar 

Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5(6):649–55.

PubMed  Google Scholar 

Parodi RL, Lagrutta M, Tortolo M, et al. A multicenter prospective study of 515 febrile neutropenia episodes in Argentina during a 5-year period. PLoS ONE. 2019;14(10):e0224299.

PubMed  PubMed Central  Google Scholar 

Sereeaphinan C, Kanchanasuwan S, Julamanee J. Mortality-associated clinical risk factors in patients with febrile neutropenia: a retrospective study. IJID Reg. 2021;1:5–11.

PubMed  PubMed Central  Google Scholar 

Görük M, Dal MS, Dal T, et al. Evaluation of febrile neutropenic patients hospitalized in a hematology clinic. Asian Pac J Trop Biomed. 2015;5(12):1051–4.

Google Scholar 

Crawford J, Dale DC, Lyman GH. Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management. Cancer. 2004;100(2):228–37.

PubMed  Google Scholar 

Ferdu E. Clinical, laboratory, treatment profiles and outcome of neutropenic fever among high-risk hematologic patients in Tikur Anbessa specialized hospital. 2019.

Safari LC, Mloka D, Minzi O, Dharsee NJ, Reuben R. Prevalence of blood stream infections and associated factors among febrile neutropenic cancer patients on chemotherapy at Ocean Road Cancer Institute, Tanzania. Infect Agents Cancer. 2023;18(1):52.

Google Scholar 

Shelke A, Priya P, Mishra S, et al. Investigation of antimicrobial susceptibility patterns, risk factors and their impact on mortality in cancer patients at a tertiary care cancer hospital—a prospective study. Ann Clin Microbiol Antimicrob. 2024;23(1):59.

PubMed  PubMed Central  Google Scholar 

Babu KG, Lokanatha D, Lakshmaiah K, et al. Bloodstream infections in febrile neutropenic patients at a tertiary cancer institute in South India: a timeline of clinical and microbial trends through the years. Indian J Med Paediatr Oncol. 2016;37(03):174–82.

PubMed  PubMed Central  Google Scholar 

De Pauw B, Walsh TJ, Donnelly JP, et al. Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses study group (EORTC/MSG) consensus group. Clin Infect Dis. 2008;46(12):1813–21.

De Naurois J, Novitzky-Basso I, Gill M, Marti FM, Cullen M, Roila F. Management of febrile neutropenia: ESMO clinical practice guidelines. Ann Oncol. 2010;21:v252–6.

PubMed  Google Scholar 

Çeken S, Iskender G, Gedik H, et al. Risk factors for bloodstream infections due to extended-spectrum β-lactamase producing Enterobacteriaceae in cancer patients. J Infect Dev Ctries. 2018;12(04):265–72.

PubMed  Google Scholar 

Joudeh N, Sawafta E, Abu Taha A, et al. Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country. BMC Infect Dis. 2023;23(1):106.

PubMed  PubMed Central  Google Scholar 

Reuter S, Kern WV, Sigge A, et al. Impact of fluoroquinolone prophylaxis on reduced infection-related mortality among patients with neutropenia and hematologic malignancies. Clin Infect Dis. 2005;40(8):1087–93.

PubMed  Google Scholar 

Kern W, Klose K, Jellen-Ritter A, et al. Fluoroquinolone resistance of Escherichia coli at a cancer center: epidemiologic evolution and effects of discontinuing prophylactic fluoroquinolone use in neutropenic patients with leukemia. Eur J Clin Microbiol Infect Dis. 2005;24:111–8.

PubMed  Google Scholar 

Gafter-Gvili A, Fraser A, Paul M, Leibovici L. Meta-analysis: antibiotic prophylaxis reduces mortality in neutropenic patients. Ann Intern Med. 2005;142(12_Part_1):979–95.

PubMed  Google Scholar 

Comments (0)

No login
gif