Febrile neutropenia in pediatric cancer patients: Experience from a tertiary health care facility of Pakistan

AimsPediatric cancer patients with febrile neutropenia (FN) have an increased risk of infectious complications and mortality.MethodsThis study was a retrospective analysis of pediatric cancer patients with FN.ResultsOut of 872 episodes of FN, 559 (64.1%) were males and 313 (35.9%) females. The mean age was 5.32 ± 4.07 years. ALL (67.7%) was the most common diagnosis followed by AML (12.2%), lymphoma (9.9%) and solid tumors (5.8%). Age < 5 year (Odd Ratio = 1.5; p = 0.043), AML (OR = 1.8; p = 0.019), patients who received chemotherapy within 2 week of FN (OR = 1.9; p = 0.007), absolute neutrophil count < 50/cm (OR = 1.5; p < 0.041), platelets count < 50,000/cm (OR = 1.5; p < 0.027), fungal infection (OR = 15.6; p < 0.001), and pneumonia were identified as risk factors associated with development of prolonged FN in pediatric cancer patients. A total of 25 (2.9%) patients required PICU admission and 12 (1.4%) patients expired. Both variables, PICU admission (9% Vs 2%; OR = 5.4; p < 0.001) and mortality rate (5.2% Vs 0.8%; OR = 8.1; p < 0.001) were statistically significant in patients with prolonged FN versus FN respectively.ConclusionProspective studies in large cooperative trials may be beneficial in evaluating these risk factors further.