Characterization of neutropenic fever in patients receiving first-line adjuvant chemotherapy for epithelial ovarian cancer.
OBJECTIVE
Limited information is available on the incidence and characteristics of neutropenic fever (NF) in patients receiving contemporary regimens for epithelial ovarian cancer (EOC). We examined this issue in patients receiving first-line adjuvant chemotherapy with platinum- and paclitaxel-based regimens at a major cancer institute.


METHODS
Charts of patients with EOC at a single institute from 1998 through 2002 were reviewed. Data were collected on the incidence and duration of NF, duration of hospitalization and fever, cultures, antibiotic and chemotherapy regimen, and type of debulking procedure.


RESULTS
140 patients were treated for EOC. 125 patients received first line chemotherapy. 15 episodes of NF were observed. Mean duration of neutropenia and fever was 2.33 and 3.07 days respectively. 9 of 15 (60%) NF episodes occurred after cycle 1. Cultures were positive in 7 of 15 patients (47%). Organisms most frequently recovered were bowel-derived. 8 patients (53%) had bowel resections, and 15 patients (100%) had radical or supraradical procedures. There was a correlation between incidence of NF and type of procedure (P = 0.01) and stage of EOC (P = 0.04). There was no correlation between NF and elderly age, medical comorbidities, and postoperative complications.


CONCLUSIONS
The rate of NF was higher than previously reported. NF occurred most frequently after cycle 1. NF patients were of advanced stage that had undergone more aggressive surgery and had bowel resections. Our data suggest that patients with advanced EOC who undergo more radical procedures should be identified as high risk for developing NF in early cycles.
Division of Gynecologic Oncology, Department of Surgery, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263, USA.
Sameer
S
Sharma
Katayoun
K
Rezai
Deborah
D
Driscoll
Kunle
K
Odunsi
Shashikant
S
Lele
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant; D004756:Enterobacteriaceae Infections / Q000150:complications / Q000209:etiology; D016983:Enterococcus / Q000302:isolation & purification; D004926:Escherichia coli / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000139:chemically induced / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology*; D006801:Humans; D007709:Klebsiella / Q000302:isolation & purification; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications* / Q000382:microbiology; D010051:Ovarian Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies
D016190:Carboplatin; D017239:Paclitaxel