High-risk febrile neutropenia and its management in children with solid tumors and lymphoma.

Turkish journal of medical sciences

PubMedID: 26281335

Köse D, Emiroglu M, Köksal Y. High-risk febrile neutropenia and its management in children with solid tumors and lymphoma. Turk J Med Sci. 2015;45(3):655-62.
BACKGROUND/AIM
The clinical characteristics and treatment results of febrile neutropenia attacks that occurred in patients with lymphoma and solid tumors were analyzed.

MATERIALS AND METHODS
A total of 50 patients with 94 high-risk attacks were evaluated for malignant diseases in this study.

RESULTS
The fever etiology was determined as clinical (50%), microbiological (5.31%), clinical-microbiological (5.31%), or unknown (39.3%). A few of the attacks (21.3%) were observed in lymphoma cases and 77.7% were observed in patients with solid tumors. Patients who were in remission had 59.6% of the attacks, and 39.4% occurred in patients not in remission. Among the groups tested, 73% (the imipenem/amikacin group) and 47.9% (the piperacillin-tazobactam/amikacin group) of patients were in remission. Glycopeptide addition rates in these groups were 22.2% and 40.8% and antifungal addition rates were 8.8% and 18.3%, respectively.

CONCLUSION
Clinical progress was more problematic in patients who were not in remission during the attacks. This was due to the fact that some patients had other factors that placed them in the high-risk group, as well as increased C reactive protein and procalcitonin values on the first day. Therefore, it may not be accurate to associate the success achieved in the different treatment regimens with antibiotics alone.