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. 2020 Dec;105(6):731-740.
doi: 10.1111/ejh.13500. Epub 2020 Sep 28.

Febrile neutropenia in patients with acute myeloid leukemia: Outcome in relation to qSOFA score, C-reactive protein, and blood culture findings

Marika Lappalainen  1   2 , Sari Hämäläinen  1 , Tuomo Romppanen  2 , Kari Pulkki  3   4 , Marja Pyörälä  1 , Irma Koivula  1 , Esa Jantunen  1   2   5 , Auni Juutilainen  1   2
Affiliations

Febrile neutropenia in patients with acute myeloid leukemia: Outcome in relation to qSOFA score, C-reactive protein, and blood culture findings

Marika Lappalainen et al. Eur J Haematol. 2020 Dec.

Abstract

Objectives: To evaluate quick Sequential Organ Failure Assessment (qSOFA) score during febrile neutropenia (FN) in adult patients receiving intensive chemotherapy for acute myeloid leukemia (AML).

Methods: qSOFA score, as well as the association of qSOFA score with ICU admission, infectious mortality, blood culture findings, and C-reactive protein (CRP) measurements during FN were assessed among 125 adult AML patients with 355 FN periods receiving intensive chemotherapy in a tertiary care hospital from November 2006 to December 2018.

Results: The multivariate model for qSOFA score ≥ 2 included CRP ≥ 150 mg/L on d0-2 [OR 2.9 (95% CI 1.1-7.3), P = .026], Gram-negative bacteremia [OR 2.7 (95% CI 1.1-6.9), P = .034], and treatment according to AML-2003 vs more recent protocols [OR 2.7 (95% CI 1.0-7.4), P = .047]. Age or gender did not gain significance in the model. qSOFA score ≥ 2 was associated with ICU treatment and infectious mortality during FN with sensitivity and specificity of 0.700 and 0.979, and 1.000 and 0.971, respectively.

Conclusion: qSOFA offers a useful tool to evaluate the risk of serious complications in AML patients during FN.

Keywords: acute myeloid leukemia; febrile neutropenia; quick Sequential Sepsis-related Organ Failure Assessment score.

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References

REFERENCES

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