Factors associated with the duration of neutropenia in acute leukemia patients receiving chemotherapy at Prof. Dr. I.G.N.G. Ngoerah Hospital

Abstract

Introduction:Acute leukemia patients undergoing chemotherapy often experience febrile neutropenia. Neutropenia is defined as a neutrophil count < 500 cells/mm³. The duration of neutropenia, defined as the number of days a patient experiences a neutropenia episode, is categorized into more than 7 days (prolonged neutropenia) and less than or equal to 7 days (non-prolonged neutropenia). Methods: This cross-sectional study included a sample of 78 acute leukemia patients receiving chemotherapy at Prof Dr IGNG Ngoerah Hospital in Denpasar, observed over 4 months. Factors evaluated in relation to the duration of neutropenia included type of acute leukemia, age, gender, nutritional status, LDH levels, leukocyte levels, use of GCSF, chemotherapy, and comorbidities. Genetic factors, molecular subtypes, race, antibiotic use, and variations in chemotherapy regimens were not included in this study. Results: Out of the 78 patients, 25 (32.1%) experienced prolonged neutropenia, while 53 (67.9%) experienced neutropenia lasting less than 7 days. There was a relationship between the duration of neutropenia and comorbidities, but it was not statistically significant (p = 0.091; OR = 2.956, 95% CI: 0.841-10.397). GCSF therapy also showed a relationship but was not statistically significant (p = 0.998; OR = 364864349.738, 95% CI: 0.000). Induction chemotherapy had a significant relationship with the duration of neutropenia (p = 0.000; OR = 11.264, 95% CI: 3.121-40.646). Conclusion: Chemotherapy is currently the best treatment for acute leukemia patients, but prolonged hospitalization due to extended neutropenia duration can reduce the quality of life.