title: Febrile neutropenia in children with acute lymphoblastic leukemia: single center experience.
abstract: OBJECTIVE
  An important life-threatening complication of intensive chemotherapy administered in children with leukemia is febrile neutropenia. The objective of this study was to evaluate the clinical features and consequences of febrile neutropenia attacks in children who were treated for acute lymphoblastic leukemia.
  
  
  METHODS
  Nighty-six children who received chemotherapy for acute lymphoblastic leukemia in our center between January 1995 and December 2010 were included in the study. The data related to demographic characteristics, treatment features, relapse and febrile neutropenia incidences, risk factors, culture results and prognosis were retrospectively evaluated from the patients' files.
  
  
  RESULTS
  A total of two hundred-ninety nine febrile neutropenia attacks observed in the patients during initial treatment and relapse treatment were evaluated. When the incidence of febrile neutropenia was evaluated by years, it was observed that the patients treated after year 2000 had statistically significantly more febrile neutopenia attacks compared to the patients treated before year 2000. When the incidences of febrile neutropenia during initial treatment and during relapse treatment were compared, it was observed that more febrile neutropenia attacks occured during relapse treatment. Fifty-nine percent of all febrile neutropenia attacks were fever of unknown origin. Eighty microorganisms grew in cultures during febrile neutropenia throughout treatment in 75 patients; 86% were bacterial infections (50% gram positive and 50% gram negative), 8% were viral infections and 6% were fungal infections. Coagulase negative staphylococcus (n=17) was the most frequent gram positive pathogen; E. Coli (n=17) was the most commonly grown gram negative pathogen.
  
  
  CONCLUSIONS
  In this study, it was found that an increase in the incidence of febrile neutropenia occured in years. Increments in treatment intensities increase the incidence of febrile neutropenia while improving survival. Evaluation of febrile neutropenia results by hematology-oncology units in years will be directive in early and successful treatment.
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Özdemir
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Gülen
authors.initials: G
authors.lastname: Tüysüz
authors.affiliation: Department of Microbiology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Nigar
authors.initials: N
authors.lastname: Çelik
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Leman
authors.initials: L
authors.lastname: Yantri
authors.affiliation: Department of Public Health, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Ethem
authors.initials: E
authors.lastname: Erginöz
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Hilmi
authors.initials: H
authors.lastname: Apak
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Alp
authors.initials: A
authors.lastname: Özkan
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: İnci
authors.initials: İ
authors.lastname: Yıldız
authors.affiliation: Division of Hematology-Oncology, Department of Pediatrics, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey.
authors.forename: Tiraje
authors.initials: T
authors.lastname: Celkan
keywords: Acute lymphoblastic leukemia; child; febrile neutropenia