Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

Poster display

3469 - Development of a prognostic system to predict the response to treatment of neutropenic fever

Date

09 Oct 2016

Session

Poster display

Presenters

hamdy Zawam

Citation

Annals of Oncology (2016) 27 (6): 497-521. 10.1093/annonc/mdw390

Authors

H. Zawam1, A. Selim2, R. Salama3, N. Hanna2, W. Edesa3

Author affiliations

  • 1 Clinical Oncology Department, Cairo University, 12345 - Cairo/EG
  • 2 Clinical Oncology Department, Cairo University, Cairo/EG
  • 3 Clinical Oncology Department, Cairo University, 1 - Cairo/EG
More

Resources

Abstract 3469

Background

Febrile neutropenia (FN) remains one of the most commonly encountered oncologic emergencies in patients (pts) with hematological malignancies. Development of a prognostic system will help to improve the outcome in those pts.

Methods

This is a prospective observational study including 142 pts with haematological malignancies who presented to Kasr Al Ainy Center of Clinical Oncology during the period 1st of June 2014 to October 2015. This group of pts suffered from 270 episodes. According to the MASCC score, high risk pts were treated inpatients. All admitted pts were subjected to blood, sputum, stool and urine cultures withdrawal and Galactomann test. PCR (polymerase chain reaction) of sepsis and BAL (broncho-alveloar lavage ) were done in certain cases. Empirical antibiotics were started immediately, antifungal and antiviral tretements were recieved according to the guidelines.

Results

The different diagnostic modalities were analysed in addition to the results of treatment by different classes of antibiotics. The most frequent diagnosis in our study were AML (55 pts), followed by ALL (27pts), NHL (35 pts).The disease status was found to be highly significant and affects the control of neutropenic fever episode. The more the patient developed neutropenic episodes the more the risk of mortality. In our study, the MASCC score was highly significant. 62% of the identified pathogens were gram positive detected by blood culture, while gram negative bacteria were the commonest pathogens identified by other diagnostic modalities.

Multivariate analysis to determine pretreatment variables of independent prognostic value

Variable odds ratio 95% CI P-value Weighted partial score
Previous FN episode 1.47 0.307 7.023 0.63 -
Disease burden 3.677 1.2 11.265 0.023 2
Hypotension 5.609 1.711 18.392 0.004 3
Prevoius fungal infection 1.905 0.407 8.91 0.413 -
Uncontrolled disease 4.222 1.019 17.493 0.047 2.5
The sum of the weighted partial scores of the three significant variables resulted in a prognostic score ranging from 0 (best prognosis) to 7.5 (worst prognosis). Cutoff value of 4.5 was determined and it divides patients into two groups, ≤4.5 vs. >4.5

Conclusions

Many risk factors affect the outcome of FN and should be taken into consideration for every pt.

Clinical trial identification

Legal entity responsible for the study

Hamdy Zawam

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings