Abstract
This study was initiated to investigate the risk factors of secondary infections in febrile neutropenic patients following chemotherapy, and to evaluate the clinical, microbiological, and mortality outcomes of these infections. An evaluation was done on all patients with hematological malignancy who developed a febrile neutropenic episode (FNE) after cytotoxic chemotherapy in the Department of Hematology, Akdeniz University Faculty of Medicine, between January 2007 and December 2008. A total of 294 primary FNEs that responded to the initial empirical or targeted treatment were included in the study, and secondary infections developed after 72 (24.5%) of 294 primary FNEs. Risk factors for secondary infections were determined as acute leukemia as the underlying disease, salvage chemotherapy for refractory/relapse diseases, prolonged neutropenia (10 days and over), Multinational Association of Supportive Care in Cancer (MASSC) score < 21, and fungal infection during the primary episode. The mortality rate of patients who developed secondary infections was significantly higher compared to patients without secondary infections (27.8% and 5.4%, respectively; p = 0.001). The development of secondary infections in patients with hematological malignancy was not very rare. Greater concern should be shown for these infections to increase patient survival rates.
Highlights
This study was initiated to investigate the risk factors of secondary infections in febrile neutropenic patients following chemotherapy, and to evaluate the clinical, microbiological, and mortality outcomes of these infections
febrile neutropenic episode (FNE) that responded to the initial empirical treatment and targeted treatment
Significant differences were determined between first induction/remission induction chemotherapy and salvage chemotherapy for refractory/relapse diseases in terms of secondary infection (p = 0.031)
Summary
This study was initiated to investigate the risk factors of secondary infections in febrile neutropenic patients following chemotherapy, and to evaluate the clinical, microbiological, and mortality outcomes of these infections. Chemotherapy is one of the major approaches in cancer treatment, involving the delivery of a cytotoxic agent to the cancer cells [1] All these drugs are associated with suppression of bone marrow and severe neutropenia, which causes the patients to become vulnerable to life-threatening infections [2,3,4]. There have been a few studies in the literature investigating the frequency and risk factors of secondary infections [8,9,10,11] These secondary infections delay the round of chemotherapy, and cause prolonged hospitalization and increased mortality [8,12]. The aim of this study was to investigate the risk factors and outcomes of secondary infections developing after primary FNEs in patients with hematological malignancies
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