Crooker Kyle G, Stedman Eleanor R, Hitt Juvena R, Tompkins Bradley J, Repp Allen B
Department of Medicine, University of Vermont Medical Center, Burlington, VT.
Department of Medicine, The Larner College of Medicine at the University of Vermont, Burlington, VT.
Medicine (Baltimore). 2024 May 3;103(18):e38060. doi: 10.1097/MD.0000000000038060.
Neutropenic fever in adults undergoing chemotherapy for cancer treatment is a medical emergency and has been the focus of numerous studies. However, there is a paucity of data about non-chemotherapy induced neutropenic fever (non-CINF). We retrospectively reviewed 383 adults with neutropenic fever hospitalized at one academic medical center between October 2015 and September 2020 to characterize the frequency, causes, and outcomes of non-CINF. Twenty-six percent of cases of neutropenic fever were non-chemotherapy induced. Among these, the major causes of neutropenia were hematologic malignancy, infection, and rheumatologic disease, and the major causes of fever were infections. Patients with non-CINF had a higher 30-day mortality than those with chemotherapy induced neutropenic fever (25% vs 13%, P = .01). Non-CINF constituted > 25% of neutropenic fever events in hospitalized adults and was associated with a high mortality rate.
接受癌症化疗的成年患者出现中性粒细胞减少性发热是一种医疗急症，一直是众多研究的焦点。然而，关于非化疗引起的中性粒细胞减少性发热（non-CINF）的数据却很匮乏。我们回顾性分析了2015年10月至2020年9月期间在一家学术医疗中心住院的383例中性粒细胞减少性发热的成年患者，以描述non-CINF的发生率、病因和结局。26%的中性粒细胞减少性发热病例是非化疗引起的。其中，中性粒细胞减少的主要原因是血液系统恶性肿瘤、感染和风湿性疾病，发热的主要原因是感染。与化疗引起的中性粒细胞减少性发热患者相比，non-CINF患者的30天死亡率更高（25%对13%，P = 0.01）。在住院成人中，non-CINF占中性粒细胞减少性发热事件的比例超过25%，且与高死亡率相关。
