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

: Marika Lappalainen, Sari Hämäläinen, Tuomo Romppanen, Kari Pulkki, Marja Pyörälä, Irma Koivula, Esa Jantunen, Auni Juutilainen

Publisher: WILEY

: 2020

: European Journal of Haematology

: EUROPEAN JOURNAL OF HAEMATOLOGY

: EUR J HAEMATOL

: 105

: 6

: 731

: 740

: 10

: 0902-4441

: 1600-0609

DOI: https://doi.org/10.1111/ejh.13500

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.