Febrile Neutropenia In Pediatric Patients with Acute Leukemia During Induction Chemotherapy in Hiwa Hospital at Sulaimaniyah City, Kurdistan Region of Iraq

Abstract

Background: Febrile neutropenia (FN) is common in pediatric oncology patients, and the majority of patients with FN do not have a microbiologically defined infection, but those who do are at risk for overwhelming complications, including severe infection and death. Objectives: To determine the risk factors and treatment outcomes of FN pediatric patients with acute leukaemia during induction of chemotherapy. Patients and methods: This cross-sectional, retrospective, observational, hospital-based study was conducted on 10 years of recorded data (January 01, 2015, to January 01, 2025) of pediatric acute leukaemia patients (n=115) who developed FN during induction of chemotherapy from the Pediatric Department at Hiwa Hematology/Oncology Hospital, Sulaimaniyah, Iraq.

Results: The patients’ mean age was 8.02 ± 4.65 years with a mean body mass index (BMI) of 16.56 ± 4.46 kg/m². Most patients were aged 1.0 – 6.0 years (41.7%, n=48), males (56.5%, n=65), underweight (76.5%, n=88), had blood group A+ (43.5%, n=50), had ALL (58.3%, n=67), experienced immunosuppression (87%, n=100), had no fatigue or anxiety (59.1%, n=68), and had a body temperature of >38.5° C (58.3%, n=67). Also, majority of patients had profound neutropenia (62.6%, n=72), fever (46.1%, n=53), negative microbial cultures/identified infection (82.6%, n=95), had positive C-Reactive Protein (63.5%, n=73), received prophylactic antimicrobial (73.0%, n=84), had no abnormality on imaging (87.8%, n=101), not admitted to Intensive Care Unit (ICU)  (84.3%, n=97), and were recovered (89.6%, n=103). Consequently, no significant differences were observed in age, gender, BMI, or culture-related findings (p ≥ 0.05).

Conclusions: A chemotherapy-induced FN is a crucial life-threatening complication of the cytotoxic drugs used in the management of pediatric acute leukaemias.