Abstract 1615P
Background
Febrile neutropenia (FN) is a major complication of anti-neoplastic therapy, with significant morbidity and mortality. While granulocytes colony stimulating factors (G-CSF) and hand sanitation are proven preventive measurements, facial mask is not routinely recommended. COVID-19 pandemic led to obligatory social distancing and use of masks in public places. We aimed to assess whether these preventive measurements were associated with reduced rate of FN in patients receiving chemotherapy.
Methods
In this retrospective single-center study, all consecutive solid cancer patients treated with anti-neoplastic therapy from January 2019 to December 2021 were identified in the electronic databases of Rambam Oncology ward. Demographic and clinical data were collected. Patients classified according to time of anti-neoplastic therapy initiation as prepandemic group (2019) and pandemic group (2020). We compared the two groups in terms of FN rates and inpatient G-CSF use. FN was defined as oral temperature ≥38 with absolute neutrophil count ≤1000.
Results
Of 1666 patients who started anti-neoplastic therapy in the study period, 858 in prepandemic group and 808 in pandemic group. The median age was 65 (range 20-93), 51% females. The most common malignancies- gastrointestinal (503, 30%), lung (302, 18%), breast (242, 14.5%). Of the pandemic group, 11 (1.3%) were diagnosed with COVID-19 in the year following chemotherapy initiation. No difference found in proportion of patients with FN during the 6 months after first chemotherapy cycle (21/858, 2.4% in prepandemic vs.19/808, 2.3% in pandemic groups, p=0.898). Similarly, there was no difference in the proportion of patients with fever regardless of neutropenia (11.5% vs.13%, p=0.45). More patients in the pandemic group received G-CSF as inpatients (16% vs. 6%, p<0.0001). One year mortality was lower in the pandemic versus prependemic group (26% vs. 30%, p=0.039).
Conclusions
The implementation of obligatory face masking and social distancing during the COVID-19 era was not associated with change in NF rates. Interestingly, more patients received G-CSF, and 1 year survival was higher during the pandemic period.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.