A proposed score for predicting severe infection complications in children with chemotherapy-induced febrile neutropenia

Background: Febrile neutropenia (FN) is one of most common complications in patients with cancer during chemotherapy. Identifying factors associated with severe infectious complications (SICs) at time of admission for fever and neutropenia is necessary for better treatment.Procedure: We revised all medical charts of patients under 18 years old who developed a first episode of FN present from January 2000 to December 2003. Criteria for a SIC were defined. These included the presence of bacteremia or fungemia, sepsis, septic shock, and/or death from infection. To identify risk factors SIC was associated with the first FN episode.Results: Factors identified in univariate analysis were female sex, age less than 5 years old, acute myeloid leukemia, baseline disease activity, use of central venous catheter, hemoglobin level 38.5 degrees C, a chemotherapy interval 38.5 degrees C, hemoglobin level < 7 g/dL, any clinical focus of infection on first examination and absence of upper respiratory tract infection. the FN population was than divided among 3 different risk groups as follows: group I (low risk), group 2 (intermediate risk), with a 13 (4.4 to 38.3)-fold risk for SIC; and group 3 (high risk) with a 50 (16.4 to 149.2)-fold risk for SIC.Conclusions: This study suggests that patients with FN can be stratified for risk of SIC using clinical parameters at hospital admission.Hosp Canc AC Camargo, Ctr Tratamento & Pesquisa, Dept Pediat, BR-01509000 São Paulo, BrazilHosp Canc AC Camargo, Canc Registry, BR-01509000 São Paulo, BrazilWeb of Scienc