Chemotherapy-Induced Febrile Neutropenia in Solid Tumours

Febrile neutropaenia (FN) is defined as an oral temperature of >38.3°C or two consecutive readings of >38.0°C for 2 hours and an absolute neutrophil count (ANC) of <0.5 × 109/l, or expected to fall below 0.5 × 109/l. Fever is one of the characteristic symptoms of FN and is usually associated with the presence of an infection caused by various microorganisms. The incidence and epidemiology of FN are variable based on different factors: (type of cancer, the age/sex of the patient, chemotherapy type /number of cycles). FN remains one of the most common and risky complications of chemotherapy which occurred within 6-8 days with standard chemotherapy and it is occurred as about 7-8/1000 patients receiving treatment with chemotherapeutic agents. There is a clear relationship between the severity of neutropaenia (which directly influences the incidence of FN) and the intensity of chemotherapy. Currently, the different regimens are classified as producing a high risk (>20%), an intermediate risk (10%-20%) or a low risk (<10%) of FN. The causative organisms including either bacteria, fungi or viruses. The bacteria Gram-positive (currently dominating) and Gram-negative (Dominant in the 1970s), are usually the main microorganisms responsible for FN and cause complicated infections. Although the morbidity and mortality rates of FN have decreased over the years due to use of proper antibiotic treatment, preventive measures and use the standardrisk management plan as per guidelines but it is still one of oncological emergency. FN is responsible for considerable morbidity as 20%-30% of patient's present complications that require in-hospital management, with an overall in-hospital mortality of ~10%.