Mahmoud S Alahwal.
Pattern of febrile Neutropenia in solid tumors - a hospital based study.
Pak J Med Sci Jan ;21(3):249-52.

Objective: To review the pattern of febrile neutropenia (FN) presentations in patients with solid tumors at a university hospital in the western region of Saudi Arabia. Design: Data of all patients with solid tumors (ST) admitted with FN between November 1998 and December 2003 were collected and analyzed. Results: A total of 67 admissions of 56 patients admitted with FN. Almost two thirds (61.2%) were <50 years of age while 38.8% > 50 years. Males were 38.2% while females 67.2%. Saudis were 35.8% while non Saudis were 64.2%. Duration of neutropenia was <7days in 92.5%, 7-14 days in 7.5% and none more than 14 days. Only 16.4% presented with severe neutropenia (ANC < 100/ML). Positive cultures were found only in 11 patients (16.4%). Organisms isolated; 5 (7.5%) gram-positive bacteria, 5 (7.5%) gram-negative bacteria and fungal infection in 1 (1.5%). Medical co-morbidity was found in 25.4%. Patients were stratified in to; high (7.5%), intermediate (44.7%) and low risk (47.8%) according to the risk stratification criteria for morbidity and mortality. Treatment outcome revealed that 89.6% were alive and 10.4% were dead. Correlation of the outcome with all other variables in this study revealed that medical co-morbidity (p-value = 0.009) and risk group stratification (p-value = 0.034) were the only significant factors which have affected the outcome. Conclusion: Pattern of febrile neutropenia presentations varies between institutions. Every hospital dealing with cancer should have their own assessment and guidelines in managing such patients.

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