title: Neutropenic fever and severe sepsis in adult acute myeloid leukemia (AML) patients receiving intensive chemotherapy: Causes and consequences.
abstract: The objective of this study was to evaluate etiology and consequences of neutropenic fever in AML patients. Two hundred and ninety neutropenic periods following chemotherapy in 84 AML patients were retrospectively evaluated. Neutropenic fever was found in 280 periods (97%). Severe sepsis developed in 35 occasions (13%) and 9 patients (11%) died due to severe sepsis. In 165 episodes with neutropenic fever (59%), the potential causative organism was found in blood cultures. Gram-negative bacteria were more commonly found in patients who developed severe sepsis (40% vs. 23%, p = 0.03). CRP after 2 - 3 days from start with fever was higher in patients with severe sepsis (190 mg/L vs. 96 mg/L, p < 0.001) but the rise in CRP rather coincided than preceded with the development of severe sepsis. Severe sepsis is associated with significant mortality in AML patients. Earlier methods than CRP are needed to predict development of severe sepsis.
authors.affiliation: Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Sari
authors.initials: S
authors.lastname: Hämäläinen
authors.forename: Taru
authors.initials: T
authors.lastname: Kuittinen
authors.forename: Irma
authors.initials: I
authors.lastname: Matinlauri
authors.forename: Tapio
authors.initials: T
authors.lastname: Nousiainen
authors.forename: Irma
authors.initials: I
authors.lastname: Koivula
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005334:Fever / Q000209:etiology; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications / Q000209:etiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology* / Q000401:mortality
chemical_list: D002097:C-Reactive Protein