The risk factors for febrile neutropenia during chemotherapy in children with malignancy

Abstract

Background Febrile neutropenia is the most common side effect of myelosuppressive chemotherapy. It is important to identify its risk factors to decrease the morbidity and mortality of febrile neutropenia. Objective To identify whether age, type of malignancy, phase and dose of chemotherapy, nutritional status, and absolute neutrophyl count are risk factors for febrile neutropenia. Methods A hospital-based case control study was conducted at Hasan Sadikin Hospital from June 2000 to July 2005. Data was collected from medical records. The case group consisted of children with malignancy who received chemotherapy and suffered from febrile neutropenia, while the control group consisted of children without febrile neutropenia. Chi square and logistic regression analysis were performed to analyze data using SPSS for Windows version 13.0. Results Eighty-seven cases and 94 controls were evaluated. Analysis showed that malignancy type i.e, hematologic malignancy, chemotherapy phase, and absolute neutrophyl count might be the risk factors for febrile neutropenia (OR=4.6, 95% CI 1.3;16.7, P=0.019; OR=8.1, 95% CI 2.2;30.5, P=0.002; and OR=1.0, 95% CI 1.003;1.007, P <0.001, respectively), while age, chemotherapy dose, and nutritional status might not be the risk factors (median 60, range 6-144, P=0.342; OR=1.9, 95% CI 0.8;4.8, P=0.129; and P=0.798, respectively). Conclusion Hematologic malignancy, induction phase of chemotherapy, and absolute neutrophyl count =250/mm 3 are the risk factors for febrile neutropenia in children with malignancy who received chemotherapy.

Keywords

• chemotherapy
• febrile neutropenia
• malignancy in children