A Study On The Clinical Characteristics Of Children With Hematological Malignancies With Neutropenia And Fever After Chemotherapy

Objective: Agranulocytosis(or neutropenia)often occurs in patients with hematological malignant tumors after chemotherapy.Fever is the most common complication during this period.This article analyses the cases of agranulocytosis with fever after chemotherapy in children with hematologic malignancies in northern China,it provides a reliable basis for finding the cause of disease and treating the disease.Methods: A retrospective study was conducted to analyze the clinical features of agranulocytosis associated with fever in patients with hematologic malignancies receiving chemotherapy in pediatric hematology wards from October 2017 to June2018.Through the collection of relevant clinical features,the results of its induction,analysis and summary.Results: During this period,a total of 722 patients received regular chemotherapy in the pediatric hematology ward of the Sheng Jing Hospital.Of these,356 cases had agranulocytosis,137 cases had fever,the incidence was 38.5%.There were 3 cases of death,the mortality was 2.2%.AML has the highest incidence of fever after chemotherapy,which is 73.7%.The single factor analysis of influencing factors showed that the fever of agranulocytosis was related to the age,disease type,duration and severity of agranulocytosis(P < 0.05);the multi factor analysis showed that the duration of agranulocytosis was more than 7 days,the age of patients was less than 1year old or more than 10 years old,which was the risk factors of fever in children with hematological malignancies after chemotherapy.In the study of infection site,lung infection was the most common,67 cases(61.4%),digestive tract infection(15cases,13.8%),upper respiratory tract infection(10 cases,9.1%)were also found.93.5% of the patients used antibiotic prophylactically and 60.7%(216 times)used G-CSF.Conclusions: Agranulocytosis following chemotherapy in patients with hematologic malignancies is associated with infection in most cases,and its incidence is high.The independent risk factors of fever in children with hematological malignancies after chemotherapy include the duration of agranulocytosis > 7 days,the age of patients <1year old or≥10 years old.The positive rate of pathogen detection is not high,once fever symptoms appear,we should select the initial empirical anti-infection treatment plan in time,and evaluate the effect in time,adjust the treatment plan.