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Neutropenia and fever in cancer patient

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by

Nabil EL- hadi omar

on 27 October 2016

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Transcript of Neutropenia and fever in cancer patient

By \ Ph. Nabil El-hady
fever
Neutropenia
Neutroprnia & Fever associated with cancer chemotherapy
Definition
Causes
Risk factors
Signs and Symptoms
Consequences
Management
# Neutropenia = low Neutrophils in the blood

# so what is the problem ??


Neutrophils are very important in defending the body against bacterial infections

,



i .e

:


LOW
neutrophils =

MORE

infections
1- cancer : Cancers that affect the bone marrow & the blood directly,
( leukemia, lymphoma, and myeloma, or metastatic cancer )


2- anti-cancer: 1)
Chemotherapy
affect Bone Marrow function


2)
Radiation therapy
can also affect the bone marrow

3- other : 1) Some people are born with it.
2) It can happen after a viral infection.
3) Sometimes it happens for no known reason


BUT High risk People :

1- People with cancer who are age 70 or older

2- people with weakened immune system
Neutropenia is a blood disorder that can affect anyone

* Any redness, swelling, or pain, especially around a cut,
wound, or an intravenous (IV) catheter site.

* Unusual vaginal discharge or itching


* The patient is most susceptible to infection when neutrophils
reaches the lowest point - called “ Nadir “.
CSF
* ?
* Types ?
* Use in cancer & it's guideline ?
CSF:
Colony Stimulating Factor
Types of CSF
G-CSF
gm-CSF
It stimulate the production of neutrophil
It stimulate the production of monocyte, eosinophils in addition to neutrophils
Role in cancer
* Supportive not to treat cancer they are just to prevent pt from neutropenia and to shorten the period of hospitalization and antibiotic administration


** C-SF usally given 24 hrs after last antineoplastic dose,
why???
BREAK
fever
Epidemiology
Prophylaxis
Treatment

For febrile neutropenia
, fever
can be considered as a result
infectious complication in
neutropenic patients who are immunocompromised
Neutropenic fever

is a case of medical
emergency that may be fatal
Bacterial infections are
predominant but viral or
fungal infections may
occurred
a- Medical staff
b- Patients
c- Drugs
1- Hand washing
2- Antiseptics
3- Sterile equipments
1- Good hygiene
2- Avoid source of
infections “Isolation”
1- Antibacterial agents: as FQ ,
Vancomycin, Linezolide.

2- Antifungal agents: as Posaconazol

1
-Correction of neutropenia


( Hematopoietic Growth Factors )
2-Elimination of infection


(Antimicrobial agents)
3-Control fever


( Antipyretics)
This is a post-marketing study of Syncope (Fainting) among people who take Leukine.
The study is created by eHealthMe based on 105 reports from FDA and user community
1,131 people reported to have side effects when taking Leukine. Among them, 105 people (9.28%) have Syncope.
Refrences :
1-Clinical practice guidelines in oncology Prevention and treatment of cancerrelated infections v.1.2012 NCCN, 2012.
2-Myeloid Growth factors.
NCCN guidlines version 1.2012
3-FEBRILE NEUTROPENIA FOR HIGH RISK PATIENTS
HMC Clinical Pathway Policy No: CPW 10302
4-Hughes WT, Armstrong D, Bodey GP, et al. 2002 Guidelines for the use of antimicrobial agents in neutropenic patients with cancer. Clin
Infect Dis 2002;34:73051.
5-Klastersky J, Paesmans M, Rubenstein EB, et al. The Multinational Association for Supportive Care in cancer risk index: A multinational
scoring system for identifying lowrisk febrile neutropenia cancer patients. J Clin Oncol 2000;18:303851.
1*&4*
3*
2*
Criteria:
Temperature ≥38.3° C once or sustained ≥38° C for one hour.
Absolute neutrophil count of <500cells/mm or a count of 1000cells/mm3 with predicted decline to ≤ 500 cells/mm over the next 48 hours.
3*
Criteria:
Absolute neutrophil count of <500cells/mm or a count of 1000cells/mm3 with predicted decline to ≤ 500 cells/mm over the next 48 hours.
2*
5*
2*
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