Clinical study of chemotherapy induced febrile neutropenia: talcott’s versus multinational association for supportive care in cancer risk assessment scoring systems

Authors

  • Rachana Gaur Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India
  • Rahul Bhardwaj Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India
  • Sandeep Sharma Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India
  • Krishna Kumar Rathnam Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20205851

Keywords:

Chemotherapy, Febrile Neutropenia (FN), MASCC, Talcott’s

Abstract

Background: Cancer is a leading cause of death worldwide, accounting for 8.2 million deaths in 2012. Febrile neutropenia (FN) is fever associated with abnormally low neutrophil count signifying an immunocompromised state secondary to malignancy or its treatment. The aim of this study was to evaluate clinical outcome of chemotherapy induced febrile neutropenia.

Methods: This was a hospital based prospective, descriptive observational study. Patients of either sex, age (18-90 years), with cancer on chemotherapy, single oral temperature ≥101°Fahrenheit (38.3°C) or a temperature ≥100.4° Fahrenheit (38.0° C) for ≥ one hour with absolute neutrophil counts <500 cells/mm3 or <1000 cells/mm3 with a predicted decrease to less than 500 cells/mm3 in the next 24 hours, only with first febrile episode occurring during study period and prior or concurrent radiation therapy were included in this study.

Results: Among 87 patients, 70 (80.5%) were less than 60 years and 17 (19.5%) were ≥60 years. The mean age of study patients was 44.46±15 years, (range 18 to 77 years), 31(35.6%) were male and 56 (64.4%) were female. Talcott’s and MASCC risk predicting tool versus outcome, p values for Talcott’s and MASCC were significant (<0.05).

Conclusions: Neutropenic fever is a potentially life-threatening complication of cancer chemotherapy. MASCC and Talcott’s model can be used to identify low and high risk patients. MASCC risk index may have a better performance than the Talcott’s model in risk classification.

Author Biographies

Rachana Gaur, Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India

Consultant

Medicine

 

Rahul Bhardwaj, Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India

Assistant Professor

Ophthalmology

Sandeep Sharma, Department of Ophthalmology, Regional Institute of Ophthalmology, Sitapur, Uttar Pradesh, India

Associate Professor

Ophthalmology

Krishna Kumar Rathnam, Department of Medical Oncology, Meenakshi Mission Hospital and Research Centre, Madurai, Tamil Nadu, India

Senior Consultant and Head of the Department

Medical Oncology

References

Stewart BW, Wild CP, Christopher P. Wild, World Cancer Report 2014, International Agency for research on cancer, WHO. 2014; 92(3):157.

Weir HK, Thompson TD, Soman A, Moller B, Leadbetter S, White MC. Meeting the healthy people 2020 objectives to reduce cancer mortality, Preventive chronic disesase. 2015;12:140482.

Globocan 2013, India Fact sheet, section of cancer information, International Agency for research on cancer, WHO, Lyon, France, 2013.

WHO, 1999, Health situation in the south –East Asia Region, Regional Office for SEAR, New Delhi 1994-1997.

Indian Society of Medical and Pediatric Oncology. Indian Guidelines-Febrile Neutropenia 2002.

Naurois JDE, Novitzky-Basso I, Gill MJ, Marti F, Cullen MH, Roila F. Management of febrile neutropenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2010;21(Suppl 5):252-6.

Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34(6):730-51.

Meza L, Baselga J, Holmes FA, Liang B, Breddy J. Proc Am Soc Clin. Oncol. 2002;21:2840.

Vogel CL, Wojtukiewicz MZ, Carroll RR, Tjulandin SA, Barajas- Figueroa LJ, Wiens BL, et al. First and subsequent cycle use of pegfilgrastim prevents febrile neutropenia in patients with breast cancer: A multicenter, double-blind, placebo-controlled phase III study. J Clin Oncol. 2005;23:1178-1184.

Wisplinghoff H, Seifert H, Wenzel RP, Edmond MB. Current trends in the epidemiology of nosocomial blood stream infections in patients with haematological malignancies and solid neoplasms in hospitals in the United States. Clin Infect Dis. 2003;36(9):1103-110.

Blay JY, Chauvin F, Cesne ALe, Anglaret B, Bouhour D, et al. Early lymphopenia after cytotoxic chemotherapy as a risk factor for febrile neutropenia. J Clin Oncol. 1996;14:636-63.

Klastersky J, Paesmans M, Rubenstein EB, Boyer M, Elting L, Feld R, et al. The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000;18(16):3038:3051.

Roy V, Saxena D, Agarwal M, Bahadur AK, Mishra B. Indian J Cancer. 2010;47(4):430-6.

Doshi B, Pandya N, Shah C, Gupta A, Makwan M. Der Pharmacia Lettre. 2012;4(2):584-90.

Schelenz S. Annals of Oncology Advance Access published in Oxford J European Oncol Society. 2011;10:1093.

Crawford J, Wolff D, Culakova E, Poniewierski MS, Selby C, Dale D, et al. For the ANC Study Group. First-cycle risk of severe and febrile neutropenia in cancer patients receiving systemic chemotherapy: results from a prospective nationwide study, American Society of Hematol. 2004;4(7):2210.

Wilson-Royalty M, Lawless G, Palmer C, Brown R. Predictors of chemotherapy-related severe or febrile neutropenia: a review of the clinical literature. J Oncol Pharm Pract. 2002;7:141-7.

Talcott JA, Finberg R, Mayer RJ, Goldman L. The medical course of patients with fever and neutropenia: clinical identification of a low-risk subgroup at presentation. Arch Intern Med. 1988;148:2561-8.

Talcott JA, Siegel RD, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. J Clin Oncol. 1992;10:316-22.

Caggiano V, Stolshek BS, Delgado DJ, Carter WB. First and all cycle febrile neutropenia hospitalizations (FNH) and costs in intermediate grade non-Hodgkins lymphoma (IGL) patients on standard-dose CHOP therapy [abstract 1810]. Blood. 2001;98:431a.

Zidan J, Shetver L, Gershuny A, Abzah A, Tamam S, Stein M, et al. Prevention of chemotherapy-induced neutropenia by special honey intake. J Clin Oncol. 1998;16:3179-90.

Uys A, Rapoport BL, Anderson R. Febrile neutropenia: a prospective study to validate the Multniational Association for Supportive Care in Cancer (MASCC) risk-index score. Supp Care Cancer. 2004;2:555-60.

Pizzo PA, Robichaud KJ, Gill FA, Witebsky FG, Levine AS, Deisseroth AB, et al. Duration of empiric antibiotic therapy in granulocytopenic patients with cancer. Am J Med. 1979;67(2):194-200.

Bodey GP, Buckley M, Sathe YS, Freireich EJ. Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med. 1966;64(2):328-40.

Anaissie EJ, Fainstein V, Bodey GP. Randomized trial of beta-lactam regimens in febrile neutropenic cancer patients. Am J Med. 1988;84:581-9.

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Published

2020-12-28

How to Cite

Gaur, R., Bhardwaj, R., Sharma, S., & Rathnam, K. K. (2020). Clinical study of chemotherapy induced febrile neutropenia: talcott’s versus multinational association for supportive care in cancer risk assessment scoring systems. International Journal of Research in Medical Sciences, 9(1), 236–242. https://doi.org/10.18203/2320-6012.ijrms20205851

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Original Research Articles