FACTORS AFFECTING OUTCOME OF PEDIATRIC ONCOLOGY PATIENTS WITH FEBRILE NUTROPENIA AT JIMMA UNIVERSITY SPECIALIZED TEACHING HOSPITAL, JIMMA, ETHIOPIA

Abstract

Background: Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology. Objective: To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia. Method: We conducted a review of records of pediatric cancer patients hospitalized and treated for FN from January 1, 2020 to December 31, 2021 who met the selection criteria.Analysis was made on SPSS 26 .Chi square statistical analysis was performed to identify the association between independent variables and disease outcomes with P-value of less than 0.05,were used for testing significance. Result: A total of 65 patients (31 males and 34 females) fulfilled the selection criteria. thirteen of them died while in hospital. The mean (SD) age of patients who died was 6.07 (±3.44) years and the mean (SD) duration of neutropenia before death was 12.69 days.Eight of 13 patients had temperature ≥39 degree Celsius.Eleven of 13 patients had prolonged neutropenia.Ten children had hematologic malignancy and three had a solid tumor. Ten of the 13 patients had an absolute neutrophil count of less than 100/mm3 and eight of 13 patients had febrile neutropenic episodes grater than three . Patients with temperature ≥39℃(P=0.000), profound neutropenia(P=0.000) ,prolonged neutropenia(P=0.018) and those who had febrile neutropenic episodes grater than three(P=0.000) were more likely to die. Conclusion: The result of this study showed that temperature ≥39 degree Celsius, prolonged neutropenia , profound neutropenia and febrile neutropenic episodes grater than 3 were factors affecting outcome of patients with febrile neutropenia. Careful evaluation of these factors and assessing severity of patients’ clinical condition at time of admission can be useful for early decision-making in inpatient management and allocation of resources. Keywords: fever, neutropenia, cancer, Absolute neutrophil count , febrile neutropenia, oncologic emergency