title: Epidemiology of febrile neutropenia in children with central nervous system tumor: results from a single center prospective study.
abstract: Data regarding the epidemiology febrile neutropenia during chemotherapy for pediatric central nervous system neoplasia are scarce. Data retrieved from a prospective study performed from January 2002 to December 2004 at G.Gaslini Children Hospital, Genoa, Italy, where analyzed to evaluate proportions, rate for 1000 neutropenic days and etiology of fever in neutropenic children receiving gentle, standard, or peripheral blood stem cell transplant (PBSCT) therapy for central nervous system tumor. During the study duration, 243 periods of neutropenia (granulocyte count <1000/cmm), accounting for 3544 patient-days at risk, were documented in 62 children. A total of 72 febrile episodes were observed in 66 (27%) neutropenic periods, for a rate of 20.31. A primary febrile episode was observed in 10% of neutropenic periods after gentle chemotherapy, in 30% after standard chemotherapy, and in 48% after PBSCT (P<0.0001). The rate of primary febrile episodes was 6.19 after a gentle chemotherapy, 27.02 after standard treatment, and 31.02 after PBSCT (P<0.0001). In a multivariable regression model, the type of chemotherapy (gentle vs. standard and PBSCT) and the thresholds of granulocyte count at neutropenia onset (999-501/cmm and 500-101/cmm vs. ≤100/cmm) were the only factors significantly associated with the development of febrile neutropenia.
authors.affiliation: Infectious Diseases Unit, G. Gaslini Children Hospital, Genoa, Italy. eliocastagnola@ospedale-gaslini.ge.it
authors.forename: Elio
authors.initials: E
authors.lastname: Castagnola
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Garrè
authors.forename: Luisella
authors.initials: L
authors.lastname: Bertoluzzo
authors.forename: Sara
authors.initials: S
authors.lastname: Pignatelli
authors.forename: Marco
authors.initials: M
authors.lastname: Pavanello
authors.forename: Ilaria
authors.initials: I
authors.lastname: Caviglia
authors.forename: Silvia
authors.initials: S
authors.lastname: Caruso
authors.forename: Francesca
authors.initials: F
authors.lastname: Bagnasco
authors.forename: Cristina
authors.initials: C
authors.lastname: Moroni
authors.forename: Angela
authors.initials: A
authors.lastname: Tacchella
authors.forename: Riccardo
authors.initials: R
authors.lastname: Haupt
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D016543:Central Nervous System Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D011446:Prospective Studies