Episodes of fever in neutropenia in pediatric patients with cancer in Bern, Switzerland, 1993\u20132012

Maxime G Zermatten,Christa Koenig,Annina Von Allmen,Philipp Agyeman,Roland A Ammann

doi:10.1038/sdata.2018.304

Abstract

Fever in neutropenia (FN) is the most frequent potentially life threatening complication of chemotherapy for cancer. Prediction of the risk to develop complications, integrated into clinical decision rules, would allow for risk-stratified treatment of FN. This retrospective, single center cohort study in pediatric patients diagnosed with cancer before 17 years, covered two decades, 1993 to 2012. In total, 703 FN episodes in 291 patients with chemotherapy (maximum per patient, 9) were reported here. Twenty-nine characteristics of FN were collected: 6 were patient- and cancer-related, 8 were characteristics of history, 8 of clinical examination, and 7 laboratory results in peripheral blood, all known at FN diagnosis. In total 28 FN outcomes were assessed: 8 described treatment of FN, 6 described microbiologically defined infections (MDI), 4 clinically defined infections, 4 were additional clinical composite outcomes, and 6 outcomes were related to discharge. These data can mainly be used to study FN characteristics and their association with outcomes over time and between centers, and for derivation and external validation of clinical decision rules.

Highlights

Background & SummaryFever in neutropenia (FN) is the most common potentially lethal complication of chemotherapy for cancer[1,2]
About half of the children treated with chemotherapy for cancer develop at least one FN episode[3,4]
A bacterial infection is detected in a minority of children with FN

Summary

Introduction

Fever in neutropenia (FN) is the most common potentially lethal complication of chemotherapy for cancer[1,2]. About half of the children treated with chemotherapy for cancer develop at least one FN episode[3,4]. A bacterial infection is detected in a minority of children with FN This implies overtreatment in the majority of children with FN7,8. Such overtreatment has important negative implications on both societal and individual level. These include costs both due to antibiotics and to hospitalization[9], promotion of bacterial resistance, risk of nosocomial infections, and reduced quality of life of patients and their families during hospitalization[10]

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Methods