Prognostic Evaluation of Clinically Stable Febrile Neutropenia: Prospective Data from 921 Patients from the Finite Study

Abstract

ABSTRACT Aim: In the present study, we aimed to assess the prognostic factors and outcomes of apparently stable febrile neutropenia (ASFN) episodes. Methods: FINITE is a prospective, multicenter study to assess prognostic factors and patterns of care in patients with ASFN defined by the absence of hemodynamic instability, acute organ failure, specific sources of infection (e.g. pneumonia) or inability to take oral medication. We used a binary logistic regression model with bootstrap resampling to identify prognostic factors for serious complications in stable patients. Results: From Sep/12 to Mar/14, 921 patients with ASFN were included from 24 centers. The rates of serious complicatios and mortality were:14.6% (95%CI, 12.5 to 17%) and 2.1% (95%CI, 1.4 to 3.3%). Signifficant clinical and microbiological differences were observed in patients with or without complications. In the multivariate analysis, nine variables were independent risk factors for serious complications: European Cooperative Oncology Group performance status >1, cardiovascular disease, chronic obstructive pulmonary disease, mucositis NCI grade >1, monocytes Multivariate and bootstrap analysis of risk factors for serious complications Parameter Coeff. OR 95% CI p-value ECOG ≥2 1.39 4 1.33-3.37 0.001 Cardiovascular disease 0.81 2.2 1.15-4.47 0.01 COPD 1.01 2.7 1.68-6.77 0.001 Mucositis ≥2 1.08 2.9 1.78-4.96 0.001 Monocytes 0.99 2.6 1.66-4.96 0.001 Lymphocytes 450/mm3 0.85 2.3 1.45-4.1 0.002 Rigors 0.75 2.1 1.33-3.37 0.002 Previous treatment with corticoids 0.71 2 1.05-3.95 0.02 Malnutrition 1.20 3.3 1.68-6.46 0.01 Conclusions: This study identified risk factors for serious complications in patients with solid cancers and ASFN episodes, with potential implications on individualized therapy. Disclosure: All authors have declared no conflicts of interest.