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埃塞俄比亚亚的斯亚贝巴提库兰贝萨专科医院收治的发热性中性粒细胞减少症儿科癌症患者治疗结果的相关因素。

FACTORS ASSOCIATED WITH TREATMENT OUTCOME OF PEDIATRIC CANCERPATIENTS ADMITTED WITH FEBRILE NEUTROPENIA IN TIKURANBESSA SPECIALIZED TEACHING HOSPITAL, ADDIS ABABA, ETHIOPIA.

作者信息

Assefa Selamawit, Alemayehu Tinsae, Abebe Workeabeba

出版信息

Ethiop Med J. 2017 Jan;55(1):43-7.

Abstract

BACKGROUND

Cancer treatment is associated with variable degrees of myelosupression. Infection is often a life-threatening complication of chemotherapy-induced neutropenia, and it is also considered an oncologic emergency. Febrile neutropenia is a common, costly and potentially fatal complication in oncology.

OBJECTIVE

To assess factors affecting treatment outcome of cancer patients with chemotherapy induced febrile neutropenia.

METHOD

We conducted a review of records of pediatric patients hospitalized and treated for chemotherapy-induced febrile neutropenia from January 1, 2013 to December 31, 2013 and met the selection criteria.

RESULT

A total of 60 patients (36 males and 24 females) fulfilled the selection criteria. Twelve of them died while in hospital. The mean (SD) age of patients who died was 4.78 (±2.48) years and the mean (SD) hospital stay before death was 20.2 (±5.26) days. Ten children had hematologic malignancy and two had a solid tumor. Ten of the 12 patients had an absolute neutrophil count of less than 100/mm3 (p=0.008, OR=20.3) and a platelet count of less than 50,000/mm3. Six of the 10 children (10%) had sepsis. Patients with profound neutropenia, platelet count of less than 50,000 and sepsis were more likely to die (P=0.048, OR=7).

CONCLUSION

The result of this study showed that absolute neutrophil count of less than 100/mm3, platelet count of less than 50,000/mm3 and a diagnosis of sepsis were factors affecting outcome patients with febrile neutropenia. Careful evaluation of these factors and assessing severity of patients’ clinical condition at time of admission can be useful for triaging children with febrile neutropenia.

摘要

背景

癌症治疗与不同程度的骨髓抑制相关。感染常常是化疗引起的中性粒细胞减少症的一种危及生命的并发症,并且它也被视为一种肿瘤急症。发热性中性粒细胞减少症是肿瘤学中一种常见、代价高昂且可能致命的并发症。

目的

评估影响化疗引起的发热性中性粒细胞减少症癌症患者治疗结果的因素。

方法

我们对2013年1月1日至2013年12月31日期间住院并接受化疗引起的发热性中性粒细胞减少症治疗且符合选择标准的儿科患者的记录进行了回顾。

结果

共有60例患者(36例男性和24例女性)符合选择标准。其中12例在住院期间死亡。死亡患者的平均(标准差)年龄为4.78(±2.48)岁,死亡前的平均(标准差)住院时间为20.2(±5.26)天。10名儿童患有血液系统恶性肿瘤,2名患有实体瘤。12例患者中有10例的绝对中性粒细胞计数低于100/mm³(p = 0.008,比值比=20.3)且血小板计数低于50,000/mm³。10名儿童中有6名(10%)患有败血症。中性粒细胞显著减少且血小板计数低于50,000以及患有败血症的患者更有可能死亡(P = 0.048,比值比=7)。

结论

本研究结果表明,绝对中性粒细胞计数低于100/mm³、血小板计数低于50,000/mm³以及败血症诊断是影响发热性中性粒细胞减少症患者预后的因素。仔细评估这些因素并在入院时评估患者临床状况的严重程度,对于对发热性中性粒细胞减少症儿童进行分诊可能是有用的。

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