Factors predicting outcome in high risk febrile neutropenia in patients receiving intensive chemotherapy for acute sleukemia: A prospective, observational study from South India.

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dc.contributor.authorRajendranath, R
dc.contributor.authorBalasubramaniyum, V K K
dc.contributor.authorVijayakumar, V
dc.contributor.authorGanesan, P
dc.contributor.authorTenali, G S
dc.date.accessioned2016-02-11T10:33:06Z
dc.date.available2016-02-11T10:33:06Z
dc.date.issued2014-10
dc.description.abstractBACKGROUND: Outcome of febrile neutropenia (FN) in acute leukemia patients undergoing intensive chemotherapy from India is scanty. MATERIALS AND METHODS: A prospective, observational, single institutional study was conducted to evaluate the clinical features, microbiological aspects, risk factors influencing the outcome of high risk FN during intensive therapy in acute leukemia. RESULTS: Among 115 febrile episodes, though 94 (81.7%) had indwelling central venous catheter (CVC) at the time of diagnosis of FN, infective foci clinically were identified in 70.4% of episodes, with lung as the major site (25.2%) followed by CVC (17.4%). Microbiological documentation was possible in 33% (n = 40) episodes. Gram‑negative bacteria isolates were 58.3% and Gram‑positive isolates were 41.7% of which Pseudomonas was the predominant Gram‑negative and Staphylococcus aureus was the most common Gram‑positive isolate. Piperacillin‑tazobactam + amikacin were used as first line antibiotic in 93% episodes and second line antibiotics were necessary in 73% episodes. Granulocyte colony stimulating factor was used in 60.9% episodes of high risk FN mostly in acute myeloid leukemia consolidation patients. Eighteen episodes (15.7%) were assigned to have invasive fungal disease. Eleven (9.6%) out of 115 high risk FN had a fatal outcome. Presence of pulmonary infection predicted for fatal outcome (P = 0.02). CONCLUSION: This study reports the outcome of high risk FN in patients with acute leukemia undergoing intensive chemotherapy. Gram‑negative isolates are highly sensitive to piperacillin‑tazobactum and hence in a cost restraint scenario, carbapenems needs to be judiciously used. Focus of Infection in lungs during FN predicted higher fatal outcomes.en_US
dc.identifier.citationRajendranath R, Balasubramaniyum V K K, Vijayakumar V, Ganesan P, Tenali G S. Factors predicting outcome in high risk febrile neutropenia in patients receiving intensive chemotherapy for acute sleukemia: A prospective, observational study from South India. Indian Journal of Cancer. 2014 Oct-Dec; 51(4): 481-486.en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/172474
dc.language.isoenen_US
dc.source.urihttps://www.indianjcancer.com/article.asp?issn=0019-509X;year=2014;volume=51;issue=4;spage=481;epage=486;aulast=Rajendranathen_US
dc.subjectAcute leukemiaen_US
dc.subjectcatheter related infectionsen_US
dc.subjectfebrile neutropeniaen_US
dc.subjecthigh risken_US
dc.titleFactors predicting outcome in high risk febrile neutropenia in patients receiving intensive chemotherapy for acute sleukemia: A prospective, observational study from South India.en_US
dc.typeArticleen_US
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