Advertisement

International Journal of Clinical Pharmacy

, Volume 35, Issue 6, pp 1036–1039 | Cite as

Epidemiology of chemotherapy-induced neutropenia at a tertiary university hospital in Oman

  • Maram Abou Saleh
  • Rose Ngozi MafianaEmail author
  • Mohammed Al Za’abi
  • Ragini Vaishnav
  • Salam Al Kindi
  • Ibrahim Al-Zakwani
Short Research Report

Abstract

Background Little is known about the incidence and burden of chemotherapy-induced neutropenia (CIN) in Oman or the Arabian Gulf. Objectives To determine the epidemiology of CIN at Sultan Qaboos University Hospital in Oman. Methods A retrospective observational study of all eligible CIN episodes in adult (>18 years) patients with solid tumors and hematological malignancies at Sultan Qaboos University Hospital (SQUH) from January to December 2010. Analyses were performed using univariate statistics. Results A total of 1,357 episodes in 159 patients with a mean age of 50 ± 15 years (19–91) were evaluated. Fifty-four percent (n = 86) of the patients were female. A total of 46 % (73/159) of the patients developed CIN accounting for 15 % (210/1,357) of all episodes. Twelve percent (25/210) of these CIN episodes were associated with fever in 26 % (19/73) patients. There was significant association between CIN and chemotherapy regimen (P < 0.001), younger age (P < 0.001), low hemoglobin (Hb) levels (P < 0.001) and advanced cancer stage (P = 0.006). Conclusions This study suggests a high incidence of CIN in SQUH patients which resulted in chemotherapy delays, longer hospital stays, and inpatient mortality. CIN was significantly correlated with chemotherapy regimen, younger age, low Hb levels and cancer stage.

Keywords

Febrile neutropenia Incidence Length of hospital stay Neutropenia Oman 

Notes

Acknowledgments

The findings of this research were part of the MSc project in Clinical Pharmacy for Ms. Maram Abou Saleh. The authors would like to thank Dr. Ikram Burney, Senior Consultant Oncologist, Pharmacist Sam George, Assistant Pharmacist Said Al-Rasadi and other supporting staff for their valuable contribution.

Funding

This study did not receive any funding.

Conflicts of interest

The authors declare no conflicts of interest with respect to authorship and and/or publication of this article.

References

  1. 1.
    National Comprehensive Cancer Network (NCCN), 2013. Guidelines for prevention and treatment of cancer-related infections. Accessed 18 Aug 2013.Google Scholar
  2. 2.
    Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T, et al. 2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin Infect Dis. 2002;34(6):730–51.PubMedCrossRefGoogle Scholar
  3. 3.
    Bow EJ. Infection risk and cancer chemotherapy: the impact of the chemotherapeutic regimen in patients with lymphoma and solid tissue malignancies. J Antimicrob Chemother. 1998;41 Suppl D(90004):1–5.Google Scholar
  4. 4.
    Crawford J, Ozer H, Stoller R, Johnson D, Lyman G, Tabbara I, et al. Reduction by granulocyte-colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung-cancer. N Eng J Med. 1991;325(3):164–70.CrossRefGoogle Scholar
  5. 5.
    Al-Bahar S, Pandita R, Dhabhar B, Al-Bahar E. Febrile neutropenia in cancer patients in Kuwait: microbial spectrum and outcome. Support Care Cancer. 1994;2(6):400–2.PubMedCrossRefGoogle Scholar
  6. 6.
    Maher DW, Lieschke GJ, Green M, Bishop J, Stuart-Harris R, Wolf M, et al. Filgrastim in patients with chemotherapy-induced febrile neutropenia. A double-blind, placebo-controlled trial. Ann Intern Med. 1994;121(7):492–501.PubMedCrossRefGoogle Scholar
  7. 7.
    Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006;106(10):2258–66.PubMedCrossRefGoogle Scholar
  8. 8.
    Krell D, Jones AL. Impact of effective prevention and management of febrile neutropenia. Br J Cancer. 2009;101(Suppl 1):S23–6.PubMedCrossRefGoogle Scholar
  9. 9.
    Wilson-Royalty M, Lawless G, Palmer C, Brown R. Predictors for chemotherapy-related severe or febrile neutropenia: a review of the clinical literature. J Oncol Pharm Pract. 2002;7(4):141–7.CrossRefGoogle Scholar

Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2013

Authors and Affiliations

  • Maram Abou Saleh
    • 1
  • Rose Ngozi Mafiana
    • 2
    Email author
  • Mohammed Al Za’abi
    • 1
  • Ragini Vaishnav
    • 1
  • Salam Al Kindi
    • 3
  • Ibrahim Al-Zakwani
    • 1
    • 4
  1. 1.Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health SciencesSultan Qaboos UniversityMuscatOman
  2. 2.Department of PharmacySultan Qaboos University HospitalAl-Khodh, MuscatSultanate of Oman
  3. 3.Department of Hematology, College of Medicine and Health ScienceSultan Qaboos UniversityMuscatOman
  4. 4.Gulf Health ResearchMuscatOman

Personalised recommendations