Vanderpuye V, Yarney J, Beecham K
National Radiotherapy and Nuclear Medicine Centre, Korle-bu Teaching Hospital, P. O. Box KB 369, Accra, Ghana.
West Afr J Med. 2010 Sep-Oct;29(5):303-8. doi: 10.4314/wajm.v29i5.68249.
One in ten patients on anticancer medication will develop febrile neutropenia irrespective of tumour type. There is need to protect our patients from this fatal condition while optimising chemotherapy. This may be difficult for a poor country.
to assess the management of cancer patients with febrile neutropenia in a low resource setting.
records of 20 cancer patients with febrile neutropenia (fn) over a three-year period were retrospectively analysed. data retrieved included age, sex, type of cancer and number of cycles of chemotherapy taken. Other parameters included initial temperature, site of infection, absolute neutrophil count (ANC) at presentation and antibiotic choice. Use of antifungal drugs, duration of fever and overall treatment outcome were also assessed.
the male : female ratio was 3:2 with a median age of 24 years (range: 15 - 68 years), and a mean temperature of 38.8 oC (range 38.0-39.8 0C). Mean absolute neutrophil count was 0.2 x 109 (range: 0.0 to 0.6 x 109). Thirteen (65%) received Cisplatin, five (25%) received Adriamycin, two (10%) received Paclitaxel or Cyclophosphomide-Methotrexate-5, Fluorouracil (CMF). Ten(50%) developed FN with the first cycle of chemotherapy, and six(30%) in the second cycle. Twelve (60%) had oral infection, four(20%) had gastroenteritis and single episodes of respiratory and urinary tract infections. Eleven (55%), received Ceftriaxone and Gentamycin, five (25%) cases received Levofloxacin or ciprofloxacin and Amoxicillin/clavunate + metronidazole; two cases(10%), Ceftazidime and Gentamycin; two cases(10%) received Meropenem. Twelve (60%) patients had antifungal therapy for oral candidiassis. Eight (40%) patients received growth factors. The mean fever duration was 4.5 days (range 1-10 days). Two (10%) of the patients died.
febrile neutropenia in resource limited countries can be managed with good history and physical examination skills. Aminoglycosides are important components of empiric treatment in Ghana.
十分之一接受抗癌药物治疗的患者会发生发热性中性粒细胞减少症，与肿瘤类型无关。在优化化疗的同时，有必要保护我们的患者免受这种致命疾病的侵害。对于一个贫穷国家来说，这可能很困难。
评估资源匮乏地区发热性中性粒细胞减少症癌症患者的管理情况。
回顾性分析20例发热性中性粒细胞减少症（FN）癌症患者在三年期间的记录。检索的数据包括年龄、性别、癌症类型和接受化疗的周期数。其他参数包括初始体温、感染部位、就诊时的绝对中性粒细胞计数（ANC）和抗生素选择。还评估了抗真菌药物的使用、发热持续时间和总体治疗结果。
男女比例为3:2，中位年龄为24岁（范围：15 - 68岁），平均体温为38.8℃（范围38.0 - 39.8℃）。平均绝对中性粒细胞计数为0.2×10⁹（范围：0.0至0.6×10⁹）。13例（65%）接受顺铂治疗，5例（25%）接受阿霉素治疗，2例（10%）接受紫杉醇或环磷酰胺-甲氨蝶呤-5-氟尿嘧啶（CMF）治疗。10例（50%）在化疗第一周期发生FN，6例（30%）在第二周期发生。12例（60%）有口腔感染，4例（20%）有肠胃炎，并有呼吸道和泌尿道感染的单发病例。11例（55%）接受头孢曲松和庆大霉素治疗，5例（25%）接受左氧氟沙星或环丙沙星以及阿莫西林/克拉维酸+甲硝唑治疗；2例（10%）接受头孢他啶和庆大霉素治疗；2例（10%）接受美罗培南治疗。12例（60%）患者因口腔念珠菌病接受抗真菌治疗。8例（40%）患者接受生长因子治疗。平均发热持续时间为4.5天（范围1 - 10天）。2例（10%）患者死亡。
资源有限国家的发热性中性粒细胞减少症可以通过良好的病史和体格检查技能进行管理。氨基糖苷类药物是加纳经验性治疗的重要组成部分。
