Evaluate the Outcome of Chemotherapy-Induced Neutropeniain Children with Haematological Cancer

Joy A, Sajith M, Bafna v, Mathew J and Varghese A

Published on: 2019-12-30

Abstract

Background: Chemotherapy-induced neutropenia (CIN) is related to the risk of life-threatening infections, treatment delay, dose reduction and increased treatment cost.

Aim: To evaluate the outcomes of Chemotherapy- induced Neutropenia in children with hematologic cancer.

Method: A prospective study conducted for a period from August 2017 to March 2019 in a tertiary care hospital of Pune. Children with haematological cancer receiving systemic chemotherapy &presenting with an absolute neutrophils count <1000/mm³ were included in the study. Demographic details, phases of chemotherapy, previous neutropenia attacks, absolute neutrophils count, duration of neutropenia, complications due to neutropenia, and laboratory findings were noted in patient proforma. The association between complication of Chemotherapy- induced neutropenia and neutrophil count were compared using students ‘t’ test and a p-value of <0.05 was considered significant.

Results: A total of 584 episodes of Chemotherapy- induced neutropenia were reported in 50 patients. The majority were males (74%), aged below 6 years (66%). Maximum patients with neutropenia were in consolidation phase (28.2%). During the treatment cycles, 49.7% had single neutropenia attack, while 50.3%experienced recurrent attack. The highest reported complication due to Chemotherapy- induced neutropenia was respiratory tract infection (35.1%) in 205 cycles followed by febrile neutropenia (32.19%) in 188 cycles. Treatment delay (46%) and dose reduction (36%) occurred in patients due to Chemotherapy- induced neutropenia.

Conclusion: Majority of the paediatric cancer patients had respiratory tract infection, febrile neutropenia and gastrointestinal infection during neutropenic episodes. This led to treatment delay and dose modifications. Hence, quick evaluation and identification of chemotherapy- induced neutropenia help improve patient care.