Original Research

Risk factors and predictors of adverse outcomes of in paediatric febrile neutropenia

Motunrayo O. Adekunle, Alan Davidson, Marc Hendricks
South African Journal of Oncology | Vol 7 | a232 | DOI: https://doi.org/10.4102/sajo.v7i0.232 | © 2023 Motunrayo O. Adekunle, Alan Davidson, Marc Hendricks | This work is licensed under CC Attribution 4.0
Submitted: 25 February 2022 | Published: 14 March 2023

About the author(s)

Motunrayo O. Adekunle, Department of Pediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
Alan Davidson, Department of Pediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
Marc Hendricks, Department of Pediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa

Abstract

Background: Febrile neutropenia (FN) is the commonest acute complication of cancer treatment in children. The identification of patients at risk for FN as well as adverse outcomes has been described.

Aim: To evaluate the prevalence and potential risk factors for FN and describe adverse outcomes in a cohort of children treated for cancer.

Setting: The study was carried out in a paediatric oncology unit in a children’s hospital, Cape Town, South Africa.

Methods: A retrospective study from 01 January 2017 to 31 December 2019 on children with cancer at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa.

Results: Two hundred and sixty-seven episodes of FN occurred in 179 patients. Independent predictors of FN were acute myeloid leukaemia (AML) (p = 0.039), acute lymphocytic leukaemia (ALL) (p = 0.020) and intensive chemotherapy (p ≤ 0.001). Mucositis (p = 0.001), central venous access device (CVAD) placement (p = 0.004), haematologic malignancies (p = 0.040), blood transfusion during FN episode (p < 0.001) and severe neutropenia (white cell counts < 0.3 × 109 cells/L) (p ≤ 0.001) were risk factors for adverse outcomes. The mortality rate from FN was 3.57%. Independent predictors of adverse outcomes in those with FN were AML (p = 0.001), CVAD placement (p = 0.019) and severe neutropenia (p = 0.005).

Conclusion: Treatment related adverse outcomes following chemotherapy-induced FN are likely in children with AML, severe neutropenia and with CVAD placement.

Contribution: Adverse outcomes from paediatric febrile neutropenia is high. There is need for clinical decision making aimed at prevention and early identification of individuals at risk.

 


Keywords

febrile neutropenia; cancer; chemotherapy; children; risk factors; adverse outcomes

Metrics

Total abstract views: 1211
Total article views: 1068


Crossref Citations

No related citations found.