Febrile neutropenia in children with acute leukemia receiving chemotherapy; Clinical, laboratory characteristics and outcome

Abstract

Background: Fever and neutropenia among the most common and serious complications of cancer chemotherapy. The diagnosis of sepsis in children with febrile neutropenia remain difficult due to non-specific clinical and laboratory signs of infect-ion, so hospitalization and empirical intravenous broad spectrum antibiotic should be initiated as early as possible. The aim of this prospective study is to describe clinical, labora-tory characteristic and outcome of febrile neutropenic episodes. Methods: One hindered seventy febrile neutropenic episodes observed in 100 children with acute leukemia receiving chemotherapy in the oncology department of child's central teaching hospital /Baghdad over a period of 10 months (from march through December 2007). Results: febrile neutropenia was frequent complication, and severe neutropenia (ANC < 200 cell/mm) was encountered in 47 episodes (27%) of total episodes. Clinical signs and symptoms suggestive of infection were evident in 38% of neutropenic episodes, the respiratory system was the most frequently affected site encountered in 17%. Microbiological documented infection found in 16% (n=27) of episodes all from local sites other than blood, bacteremia couldn't be detected in any samples. G-ve bacilli were the most frequently isolated (63%) followed by G+ve microorganisms in (37%). Fatality rate was 24% of total patients. Conclusion: This study confirmed that our laboratory is behind the global standard for isolation of causative organisms.