Evaluation of Factors Affecting Treatment Success in Febrile Neutropenic Cancer Patients

Abstract

Infections are the most frequent cause of morbidity and mortality in neutropenic cancer patients. We aimed to evaluate the characteristics of febrile neutropenic cancer patients who were consultated by the infectious disease team in a tertiary care university hospital between January through December, 1999 and to find predictors of treatments success in these patients. Medical charts of the patients were analyzed retrospectively. The febrile attacks were categorized as: “microbiologically” and “clinically documented” infections and “fever of unknown origin (FUO)”. The results of treatment were grouped as “success” or “success only after modification of treatment/failure”. Of the participants, 61% were male and the mean (± st. dev.) age was 48 ± 18 years. About 55% of the underlying diseases were hematological malignancies. The etiology of fever was undetected in 75 (45%) patients, the infection was clinically documented in 52 (31%) patients, and microbiologically documented in 40 (24%). Response to treatment was successful in 43% of the patients with neutropenic fever whereas modification of the treatment regimen was required for success in 14 patients (8.4%) and treatment was failed in another 81 (48.5%). Multivariate logistic regression modeling was used to determine statistically significant predictors of treatment success. The infection category of “FUO” and vancomycin use were found to be significant predictors of treatment success