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The Thai Journal of Pharmaceutical Sciences

Abstract

Background: Acute myeloid leukemia (AML) with febrile neutropenia (FN) had a higher incidence among hematologic malignancies. The varied incidence and risk factors predictive of FN among patients with AML were reported. Hence, this study aimed to evaluate the incidence and risk factors associated with FN in AML patients who underwent the induction phase of chemotherapy. Material and Methods: In this retrospective cohort study, patients who were newly diagnosed with AML and receiving the induction phase of the idarubicin/cytarabine 3+7 regimen or 2+5 were included between January 2008 and December 2021. The primary outcome was an incidence of FN. Risk factors for FN and the causative pathogen were presented as secondary outcomes. The Kaplan-Meier and Cox-proportional hazard models evaluated the relationship between risk factors and FN. Results: A hundred and forty-one eligible patients with a mean age of 40.7 years (standard deviation [SD] = 13.4 years) were enrolled. Among these patients, 92.2% had an Eastern Cooperative Oncology Group score of 1–2. Twenty-five patients (17.7%) received the 2+5 regimen, and 116 (82.3%) underwent the 3=7 regimen. The average length of hospital stay was 33.9 days (SD = 7.0 days). The median absolute neutrophil count was 1,784.8 cells/mm3 (interquartile range [IQR] = 4,880.1 cells/mm3). Sixty-four (45.4%) of patients received granulocyte colony stimulating factor. The incidence of FN among patients with AML during the induction phase was 88.7%. The median time to FN was 6 days (IQR = 7.0 days). There was no significance in univariate and multivariable analyses for potential risk factors associated with FN. Gram-positive bacteria were identified as the predominant isolates, and Enterococci spp. was the most common pathogen. Conclusion: This study revealed a high incidence of FN among newly diagnosed AML patients receiving induction-phase chemotherapy. With some limitations, a significant association between FN and risk factors was not determined.

DOI

10.56808/3027-7922.2837

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