Relationship between episodes of fever and neutropenia and five-year
survival rate for children with cancer, treated at a public pediatric
hospital in Santiago, Chile.
Background: Cancer is one of the most significant
non-transmissible diseases at public health level, and febrile
neutropenia (FN) one of its most serious life threatening complications.
Objective: To estimate 5-year survival rates for children with
cancer and FN from a referral health center in Santiago, Chile, by
clinical-demographic variables. Method: Prognostic and analytic
historical cohort survival study. (FONDECYT nº 1090194, 2009-2011).
Results: 116 subjects were included, and grouped in three
categories, by type of cancer: 1) leukemia/lymphomas (51.7%), 2)
osteosarcoma (25.9%) and 3) another type of solid organ tumors
(22.4%), the median number of days between chemotherapy and the first
episode of FN was 5 days [1-7], 7 [7-8] and 7 [5-8]
respectively. The five year overall specific survival rate was 64.7%.
There were protective factors identified through Cox Model: age, post
cancer comorbidity and average educational level of the caregiver. Risk
factors identified were: presence of another type of solid organ tumor
(HR 3.43 95% CI 1.64-7.19), sepsis (HR 2.89 95% CI 1.47-5.70), delay
in chemotherapy treatment (HR 2.94 95% CI 1.17-7.40) and invasive
fungal infection (HR 3.36 95% CI 1.22-9.22). Conclusion: This
is the first pediatric study in Chile to analyze prognostic factors in
children with cancer and FN. The predictor variables that were
identified comply with previous reports from international literature.