Abstract:
Objective To investigate the effective treatment of neutropenia in patients with malignant tumor chemotherapy and the prevention and treatment of concurrent infection.
Methods A total of 25 patients with neutropenia after chemotherapy were enrolled in the Department of Oncology, Wujin Hospital Affiliated to Jiangsu University from December 31, 2015 to September 30, 2017. There were 15 males and 10 females, aged from 39 to 72 years old with a mean age of (58.64 ± 10.57) years. The clinical data, combined bacterial infections, treatment programs (treatment for increase the leukocyte, use of antibiotics), and outcome were retrospectively analyzed.
Results The main clinical manifestation was fever (64.0%, 16/25), of which 10 (40.0%) were febrile neutropenia (FN), fatigue [68.0% (17/25)], diarrhea [16.0% (4/25)] and cough and sputum [8.0% (2/25)]. The temperature of 12 (75.0%) patients with febrile neutropenia returned to the normal range after 2-5 days of treatment. After treatment, 12 (70.6%) patients had remission of fatigue; 3 (75.0%) cases of diarrhea were cured, 1 (25.0%) cases improved. Neutrophils recovered to normal levels in 21 (84.0%) patients with neutropenia after 3 to 8 days of recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration, and the neutrophils of 3 (12.0% ) cases returned to normal level after using rhG-CSF 8 to 12 days. The rate of sputum culture was 8% (2/25), the positive rate was 4% (1/25). And the rate of blood culture was 40% (10/25), the positive rate was 8% (2/25). A total of 17 (68.0%) patients received antibiotic prophylaxis, of whom 6 (24.0%) received dual antibiotic therapy. 3 (12.0%) patients died (death caused by septic shock, acute myocardial infarction and pericardial tamponade).
Conclusions rhG-CSF therapy for neutropenia was effective. For patients with febrile neutropenia, antimicrobial agents should be used empirically as soon as possible, and the antibacterial drugs should be rapidly adjusted after the pathogenic bacteria are diagnosed, thus reducing serious complications and mortality caused by bacterial infections.
Key words:
Neoplasms,
Antineoplastic Combined Chemotherapy Protocols,
Neutropenia,
Infection,
Granulocyte colony-stimulating factor
Yungang Liu, Linghui Deng, Qi Zhu, Yue Wang, Wenbin Lu, Jianhua Jin. Treatment and therapeutic efficacy of neutropenia induced by chemotherapy for malignant tumors[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2017, 03(06): 348-352.