Management of Febrile Chemo-Induced Neutropenia: Experience of The Pediatric Hemato-Oncology Unit of The Donka National Hospital

Abstract

M. M Diop, A. Barry, I. S Diallo, M. A Bangoura, M. A Doukoure, Toure A. O, O. O kolie, A. Ngba and M. Kouyate

Introduction Chemo-induced febrile neutropenia is a severe complication of cancer chemotherapy. Its severity is essentially linked to the depth and duration of neutropenia.

The aim of our work is to report the epidemiological, clinical, therapeutic and progressive particularities of episodes of chemo-induced febrile neutropenia from September 2021 to February 2023.

Methods This is a cross-sectional, observational, analytical study of episodes of febrile neutropenia post-chemotherapy lasting eighteen (18) months from September 1, 2021 to February 28, 2023.

Results There were 60 episodes of febrile neutropenia in 31 boys and 21 girls (sex ratio 1.47). The average age of the patients was 5.5 years (6 months - 17 years). The underlying neoplastic pathology was dominated by acute lymphoblastic leukemia (38.34%) and Burkitt lymphoma (23.33%). The average time to onset of febrile neutropenia was 7.72 days after chemotherapy. Fever was clinically documented in 81.67% of cases, with a predominance of digestive (55%) and respiratory (17%) foci. A pathogen was identified in 3.33% of cases.

The average time to management of febrile neutropenia during our study was 30 hours after onset with a minimum of 1 hour and a maximum of 244 hours. The median is 26 hours.

Conclusion At the end of this work, we emphasize the need for rapid and appropriate management of febrile neutropenia with empirical antibiotic therapy adapted after clinical and bacteriological investigation. We also emphasize the need to improve the means of microbiological investigations, to develop preventive measures and to respect hygiene measures in order to reduce the incidence of infection, by informing and educating all patients undergoing chemotherapy.

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