O1-008 - Self-Assessment System of Febrile Neutropenia (FN) by Patients Receiving Ambulatory Chemotherapy for Solid Tumor

Abstract

ABSTRACT Background Febrile neutropenia is one of the oncology emergencies, which usually should be timely assessed and treated at the hospital. In some areas of Japan, however, medical resources are limited in especially nights and holidays. In Hyogo Cancer Center department of medical oncology, majority of patients have breast and gynecologic (GYN) malignant disease, those who are relatively young and without COPD. These patients may be managed by a self-assessment system of FN, although the feasibility is still unknown. Methods Self-assessment system consists of three steps, such as prescription of Ciprofloxacin 1200 mg b.i.d., educating patients by the team (doctors, pharmacists, and nurses) with written material, and evaluation at the hospital if febrile episode (FE) continues for longer than 48 h. FE is defined as body temperature higher than 38°C. Frequency of FE, admission to the hospital, ICU stay, and 30 days mortality rate were assessed retrospectively. Results From August 2006 to October 2011, 476 patients were treated in ambulatory chemotherapy center under self-assessment system. The median age was 58 years (range 17–82), 87% of them were under 60 years old. The literacy rate was 100%. All had solid tumors, 75% of them had breast (n = 157) or GYN (ovary and primary peritoneal cancer; n = 155, cervix; n = 40, corpus; n = 4) malignancy. Platinum-based regimens (n = 184) and anthracycline based regimens (n = 131) were dominant. FE occurred in 159 patients (33.4%). Forty-three patients (9%) were admitted to the hospital. Two patients were admitted to ICU. The thirty-day mortality rate was 0 %. The median MASCC score of admitted patients was 21 (range 14–21). About half (47%) had high risk score (≤20). Conclusions In areas with limited resources, self-assessment of FN can be an alternative option, although that should be applied to young and literate patients educated by skilled medical team.