Chemotherapy-induced febrile neutropenia in acute myeloblastic leukemia: A single- center study of adult patients

Abstract

Introduction: Management of febrile neutropenia (FN) depends on several elements. Despite their importance, tunisian data were poor.Aim: To describe the clinical, microbiological and therapeutic profile of chemotherapy-induced FN during acute myeloblastic leukemia (AML).Methods: This observational cohort study, conducted in hematology department of Aziza Othmana hospital, included all intensive chemotherapy-induced FN episodes observed in patients aged ≥18 years and diagnosed with AML in 2021. Data were retrospectively collected and descriptively analyzed.Results : Among 33 patients, 121 FN episodes were studied. They were observed respectively during induction (52.1%), consolidation (38.8%) or salvage therapy (9.1%) cycles. Episodes were labeled as fever ofunknown origin (29.8%), clinically documented infection (51.2%) and microbiologically documented infection (MDI) (19.0%). Clinical infectious sites were skin/soft tissue (44.6%), gastrointestinal tract (27.3%), respiratory tract (27.3%) and otorhinolaryngology tract (5.0%). Gram-positive cocci and Gram-negative bacilli were isolated respectively in 18 and 15 cases, with CoNS and Klebsiella pneumoniae being the commonest. Multidrug-resistant organisms were observed in nine episodes. Extended-spectrum-beta-lactamase was the most common resistance mechanism. An intensive care unit treatment was required in 13 episodes and noted in two episodes. Sepsis was observed in 28.1% of episodes. FN-related mortality was 7.4%, associated with sepsis, pneumonia and MDI.Conclusion: Better supportive care strategies may improve infectious outcome in AML patients undergoing chemotherapy.