Study Identifies Factors for Reducing Febrile Neutropenia
Disruptions in barrier integrity, use of corticosteroids, and use of intravenous antibiotics prior to chemotherapy may increase risk of febrile neutropenia.
Corticosteroid use and select dermatologic and mucosal conditions appear to be associated with developing febrile neutropenia (FN) and should be considered in prophylaxis use and FN prediction modeling, according to researchers of a new study published in JNCCN. The investigators attested that the use of corticosteroids may be significantly associated with increased risk of FN (adjusted hazard ratio [aHR], 1.53; 95% confidence interval [CI], 1.17-1.98; P < .01). In addition, select dermatologic/mucosal conditions and intravenous (IV) antibiotic use were also found to be marginally associated with increased risk of FN.
Chun Rebecca Chao, PhD, Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena, California, and colleagues retrospectively looked at 15,971 patients diagnosed with non-Hodgkin lymphoma or breast, lung, colorectal, ovarian, or gastric cancers. All the patients were treated between 2000 and 2009 with myelosuppressive chemotherapy. The researchers collected all data using electronic medical records and conducted multivariable Cox modeling to evaluate associations between various factors and the risk of FN.
The researchers found that 4.3% of the 15,971 patients developed FN in the first chemotherapy cycle. The study revealed that longer-term use and more recent use of corticosteroids appeared to increase the risk of FN the most, leading to 3 and 2 times the risk, respectively. Certain dermatologic and mucosal conditions (including gastritis, dermatitis, and psoriasis) — as well as the use of IV antibiotics prior to chemotherapy — were also associated with higher risk of FN during the first chemotherapy cycle.
- Family L, Li Y, Chen LH, Page JH, Klippel ZK, Chao C. A study of novel febrile neutropenia risk factors related to bone marrow or immune suppression, barrier function, and bacterial flora. J Natl Compr Canc Netw. 2018;16(10):1201-1208.