ABSTRACT

Objective: To evaluate the incidence, presentation, treatment and outcome of febrile neutropenic episodes of patients treated at the Wendy Fitzwilliam Paediatric Hospital (WFPH) in Trinidad and Tobago.

Methodology: Using a retrospective cohort method, the records of all the patients registered at the Paediatric Oncology Unit at The WFPH, receiving chemotherapy for haematological or solid tumour malignancies from May 2001 to April 2008 and having episodes of febrile neutropenia were analysed.

Results: Seventy one episodes of febrile neutropenia were analysed from the 36 patient records. Episode frequency ranged from 1 to 5. The mean duration of febrile neutropenic episodes was 5.01 days (± SD 5.2), with range from 1 – 25 days. Acute Lymphoblastic Leukaemia (ALL) accounted for 43.7%. The mean WBC for the study population was 0.88 x 109/L (± SD 0.61), with the mean absolute neutrophil count (ANC) at 0.16 x 109/L (± SD 0.23). Antifungal therapy was used in 6 cases and the incidence of blood culture positive sepsis was 8.5%. Complete resolution occurred in 65 episodes.

Conclusion: Febrile neutropenia episodes treated at the WFPH have a very favourable outcome (91.5%). The further analysis of the relationships found in this study between the total white blood cell count at presentation and the duration of antimicrobial therapy, the duration of the febrile neutropenic episodes and outcome is needed.