Castelán-Martínez Osvaldo D, Rodríguez-Islas Felipe, Vargas-Neri Jessica L, Palomo-Colli Miguel A, López-Aguilar Enrique, Clark Patricia, Castañeda-Hernández Gilberto, Rivas-Ruiz Rodolfo
*Facultad de Estudios Superiores Zaragoza ¶Faculty of Medicine, Universidad Nacional Autónoma de México †Clinical Epidemiology Unit, Hospital Infantil de México Federico Gómez ‡Pharmacology Department, Centro de Investigación y Estudios Avanzados del Instituto Politécnico Nacional §Onco-Hematology Department, Hospital Infantil de México Federico Gómez ∥Oncology Department, Hospital de Pediatría "Dr. Silvestre Frenk Freud" #Coordination of Health Research, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
J Pediatr Hematol Oncol. 2016 Apr;38(3):191-6. doi: 10.1097/MPH.0000000000000515.
Febrile neutropenia (FN) is a common and potentially fatal adverse drug reaction of cisplatin-based chemotherapy (CDDPBC) in pediatric patients. Hence, the aim of this study was to determine the incidence and independent risk factors for FN in pediatric patients with solid tumors treated with CDPPBC. Cohort integration was performed in the first cycle of chemotherapy with CDDPBC and patients were followed up to 6 months after the last cycle. FN was defined according to the Common Terminology Criteria for Adverse Events. Relative risks were calculated with confidence intervals at 95% (95% CI) to determine FN risk factors. Multiple logistic regression was performed to identify independent risk factors. One hundred and thirty-nine pediatric patients (median age 7.4 y, range 0.08 to 17 y) were included in the study. FN incidence was 62.5%. Independent risk factors for FN were chemotherapy regimens including anthracyclines (odds ratio [OR]=19.44 [95% CI, 5.40-70.02), hypomagnesaemia (OR=8.20 [95% CI, 1.81-37.14]), and radiotherapy (OR=6.67 [95% CI, 1.24-35.94]). It is therefore concluded that anthracyclines-containing regimens, hypomagnesaemia, and radiotherapy are independent risk factors for FN in patients receiving CDDPBC.
发热性中性粒细胞减少症（FN）是小儿患者顺铂类化疗（CDDPBC）常见且可能致命的药物不良反应。因此，本研究旨在确定接受CDPPBC治疗的实体瘤小儿患者中FN的发生率及独立危险因素。在CDDPBC化疗的第一个周期进行队列整合，并对患者随访至最后一个周期后6个月。FN根据不良事件通用术语标准进行定义。计算相对风险及95%置信区间（95%CI）以确定FN危险因素。进行多因素逻辑回归分析以识别独立危险因素。本研究纳入了139例小儿患者（中位年龄7.4岁，范围0.08至17岁）。FN发生率为62.5%。FN的独立危险因素包括含蒽环类药物的化疗方案（比值比[OR]=19.44[95%CI，5.40 - 70.02]）、低镁血症（OR=8.20[95%CI，1.81 - 37.14]）和放疗（OR=6.67[95%CI，1.24 - 35.94]）。因此得出结论，含蒽环类药物的化疗方案、低镁血症和放疗是接受CDDPBC治疗患者发生FN的独立危险因素。
