Methods: Six hundred post-chemotherapy neutropenia episodes in 123 acute myeloid and 56 acute lymphoblastic leukemia patients (median age 44 years, range 16-77; 80 female, 99 male) which had been prospectively recorded between January 2005 and April 2013, were analyzed. The diagnosis of NEC was done by the combination of clinical and radiological criteria as described by Gorschlüter, et al (Eur J Haematol 2005 ;75:1). Univariate analysis to define risk factors associated with NEC were done by Chi-square or independent samples T-test for categorical and continuous variables, respectively. Factors associated with NEC (p< .1) were included in binary logistic regression analysis to determine independent risk factors.
Results: NEC was observed in 33 of 600 (5.5%) neutropenic episodes. Use of prophylactic levofloxacin (p=.015), type of chemotherapy (induction, consolidation or conditioning) (p< .01), duration of neutropenia (p< .01) and hypertension (p= .054) as a comorbidity were associated with NEC in univariate analysis. Whereas, type of leukemia, age, gender, presence of mucositis, corticosteroid use and comorbidities other than hypertension were found to be unrelated. Only duration of neutropenia (odds ratio [95% CI] = 1.045[1.008-1.083], p= 0.017) and levofloxacin prophylaxis (odds ratio [95% CI] = 0.372[0.153-0.906], p= 0.030) remained as significant independent risk factors in the multivariate analysis. Relative odds for NEC increased by 4.5% for each additional day of neutropenia.
Conclusion: Prolonged neutropenia seems to be the main risk factor for developing NEC. Levofloxacin prophylaxis can prevent this complication.
T. Aslan, None
G. Gunes, None
U. Y. Malkan, None
S. Aydin, None
P. Zarakolu, None
M. Akova, None
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