Fatal Febrile Neutropenia in Post Chemotherapy Patient with Ovarian Dysgerminoma: A Case Report
Abstract
Introduction: Febrile Neutropenia (FN) is a condition characterized by fever and neutropenia, presents a critical concern in cancer treatment, particularly in ovarian cancer patients receiving chemotherapy. The incidence of FN is influenced by various factors, including chemotherapy regimen, patient demographics, and overall health status.
Case Presentation: A 20-year-old woman presented with abdominal distension, pain, and weight loss, indicative of advanced intra-abdominal pathology. Surgical exploration revealed extensive disease, prompting suboptimal tumor debulking and total abdominal hysterectomy with bilateral salpingo-oophorectomy. Postoperatively, the patient was at high risk for FN, necessitating vigilant monitoring and prompt intervention.
Discussion: FN in ovarian cancer patients underscores the complexity of treatment, as chemotherapy-induced neutropenia significantly increases infection susceptibility. Prophylactic measures, including granulocyte colony-stimulating factors (G-CSFs) and antimicrobial therapy, play a crucial role in reducing FN incidence and severity. Early detection and prompt antibiotic initiation are essential in managing FN effectively.
Conclusion: The case report highlights the challenges of managing ovarian cancer and the importance of proactive FN management. By prioritizing personalized care and early intervention, healthcare providers can optimize outcomes and enhance patient quality of life.Keywords
References
A, R. (2016). Febrile Neutropenia in Cancer Patient: Epidemiology, Microbiology, Pathophysiology and Management. Journal of Cancer Prevention & Current Research, 5(3). https://doi.org/10.15406/jcpcr.2016.05.00165
Ali, C., Ahmed, S., Sadia, B., Ahmed, A., & Chiragh, S. (2022). Indiana Journal of Agriculture and Life Sciences Frequency of Chemotherapy Induced Febrile Neutropenia: A Tertiary Care Hospital Study the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0). In Indiana Journal of Agriculture and Life Sciences (Vol. 2, Issue 1). https://indianapublications.com/journal/IJALS
Alyamani, M. J., AlSalloum, H., Elgohary, G., Alsaleh, K., Abd El Warith, A., & Abd El-Aziz, N. (2022). Granulocyte Colony-Stimulating Factor Utilization and Prescribing Patterns in Cancer Patients: A Single Institution Experience of a Saudi Cancer Center. Cureus. https://doi.org/10.7759/cureus.27017
Budiana, I. N. G., & Febiani, M. (2017). Febrile Neutropenia pada Pasien Pascakemoterapi. Indonesian Journal of Cancer, 11(2), 77. https://doi.org/10.33371/ijoc.v11i2.505
Crawford, J., Herndon, D., Gmitter, K., & Weiss, J. (2024). The impact of myelosuppression on quality of life of patients treated with chemotherapy. Future Oncology, 1–16. https://doi.org/10.2217/fon-2023-0513
Da Silva, R., & Casella, T. (2022). Healthcare-associated infections in patients who are immunosuppressed due to chemotherapy treatment: a narrative review. The Journal of Infection in Developing Countries, 16(12), 1784–1795. https://doi.org/10.3855/jidc.16495
Griffiths, E. A., Roy, V., Alwan, L., Bachiashvili, K., Baird, J., Cool, R., Dinner, S., Geyer, M., Glaspy, J., Gojo, I., Hicks, A., Kallam, A., Kidwai, W. Z., Kloth, D. D., Kraut, E. H., Landsburg, D., Lyman, G. H., Mahajan, A., Miller, R., … Pluchino, L. (2022). NCCN Guidelines® Insights: Hematopoietic Growth Factors, Version 1.2022. Journal of the National Comprehensive Cancer Network, 20(5), 436–442. https://doi.org/10.6004/jnccn.2022.0026
Hu-Heimgartner, K., Lang, N., Ayme, A., Ming, C., Combes, J., Chappuis, V. N., Vazquez, C., Friedlaender, A., Vuilleumier, A., Bodmer, A., Viassolo, V., Sandoval, J. L., Chappuis, P. O., & Labidi-Galy, S. I. (2023). Hematologic toxicities of chemotherapy in breast and ovarian cancer patients carrying BRCA1/BRCA2 germline pathogenic variants. A single center experience and review of the literature. Familial Cancer, 22(3), 283–289. https://doi.org/10.1007/s10689-023-00331-6
Joudeh, N., Sawafta, E., Abu Taha, A., Hamed Allah, M., Amer, R., Odeh, R. Y., Salameh, H., Sabateen, A., Aiesh, B. M., & Zyoud, S. H. (2023). Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country. BMC Infectious Diseases, 23(1), 106. https://doi.org/10.1186/s12879-023-08058-6
Klastersky, J., de Naurois, J., Rolston, K., Rapoport, B., Maschmeyer, G., Aapro, M., & Herrstedt, J. (2016). Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Annals of Oncology, 27, v111–v118. https://doi.org/10.1093/annonc/mdw325
Laali, E., Fazli, J., Sadighi, S., Mohammadi, M., Gholami, K., & Jahangard-Rafsanjani, Z. (2020). Appropriateness of using granulocyte colony-stimulating factor (G-CSF) for primary prophylaxis of febrile neutropenia in solid tumors. Journal of Oncology Pharmacy Practice, 26(2), 428–433. https://doi.org/10.1177/1078155219875507
Leon Rapoport, B., Garcia-Morillo, M., Font, C., Samoon, Z., Jabbar, A. A., Kourie, H. R., Kayumba, A., Esposito, F., Popescu, R. A., García-Gómez, J., Heyman, L., Smit, T., Krendyukov, A., Mathieson, N., Cooksley, T., Anderson, R., & Klastersky, J. (2023). A prospective, real-world, multinational study of febrile neutropenia (FN) occurrence in oncology patients receiving chemotherapy with intermediate risk of FN: a MASCC Neutropenia, Infection, and Myelosuppression Study Group initiative. Supportive Care in Cancer, 31(11), 628. https://doi.org/10.1007/s00520-023-08071-0
Mansoor, M., Shakil, F., Jalal, U., Shahid, F., Jamal, M., Ali, A. S., Abbasi, F. A., Hijazi, H., Imran, H., Hirani, S., Javaid, A., Abu Bakar, A., Shah, A. A., Varrassi, G., Khatri, M., & Kumar, S. (2023). Comparison of the Efficacy of Cisplatin/Paclitaxel Versus Carboplatin/Paclitaxel in Improving Survival and Quality of Life in the Advanced Ovarian Cancer Patient Population: A Systematic Review and Meta-Analysis of Randomized Control Trials. Cureus. https://doi.org/10.7759/cureus.51011
Nielson, C. M., Bylsma, L. C., Fryzek, J. P., Saad, H. A., & Crawford, J. (2021). Relative Dose Intensity of Chemotherapy and Survival in Patients with Advanced Stage Solid Tumor Cancer: A Systematic Review and Meta-Analysis. The Oncologist, 26(9), e1609–e1618. https://doi.org/10.1002/onco.13822
Nur Utomo, F., Zaky Romadhon, P., & Bhadra Nareswari, A. (n.d.). Title: ANALYSIS OF MYELOSUPPRESSION IN POST-CHEMOTHERAPY BREAST CANCER PATIENTS (A Study at Division of Hematology and Medical Oncology Airlangga University Hospital). https://doi.org/10.1101/2024.01.31.24302087
Suzuki, K., Sasada, S., Kimura, Y., Emi, A., Kadoya, T., & Okada, M. (2022). Effect of Secondary Prophylactic G-CSF on the Occurrence of Febrile Neutropenia in Breast Cancer. Anticancer Research, 42(12), 5945–5949. https://doi.org/10.21873/anticanres.16104
Vergote, I., Denys, H., De Greve, J., Gennigens, C., Van De Vijver, K., Kerger, J., Vuylsteke, P., & Baurain, J. F. (2020). Treatment algorithm in patients with ovarian cancer. Facts, Views & Vision in ObGyn, 12(3), 227–239.
Xu, Y., Wei, M., Cheng, X., & Li, X. (2023). Chemotherapy-Induced Neutropenia as a Prognostic Factor in Patients With Advanced Epithelial Ovarian Carcinoma. Cancer Control, 30. https://doi.org/10.1177/10732748231183496
Yoo, J., Jung, Y., Ahn, J. H., Choi, Y. J., Lee, K. H., & Hur, S. (2020). Incidence and clinical course of septic shock in neutropenic patients during chemotherapy for gynecological cancers. Journal of Gynecologic Oncology, 31(5). https://doi.org/10.3802/jgo.2020.31.e62
DOI: 10.24815/jks.v24i2.39336
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