Abstract:
Background: Febrile neutropenia (FN) is frequently arises because of bone marrow suppression
caused by chemotherapy or radiotherapy. However, information regarding clinical characteristics,
associated factors and treatment outcomes of pediatric cancer patients in Ethiopia is scarce.
Objective: To assess clinical characteristics, associated factors and treatment outcomes of pediatric
cancers among pediatric cancer patients who received chemotherapy at pediatric
hematology/oncology ward, of Jimma Medical Center, Ethiopia.
Methods: A retrospective cohort study design was conducted. All children who received cancer
chemotherapy between August 2017 and January 2022 were included. Data was checked and entered
into Epi-data version 4.6 and exported to SPSS version 26.0 for statistical analysis. Descriptive
statistics was used to describe the findings. Bivariate and multivariate logistic regression was
performed to determine the factors associated with endpoints. The effect size was reported using
odds ratio along with a 95% confidence interval (CI) and a p-value of 0.05 was used to declare the
statistical significance.
Result: Seventy-six (71.7%) of the patients had clinically documented FN associated infections and
92(29.4%) of the patients were died. Hematologic tumors (AOR = 4.16 (95% CI 2.26, 7.65) P<
0.0001), tumor metastasis (AOR = 4.56 (95% CI 2.36, 8.79), P < 0.0001), low baseline neutrophil
count (AOR = 1.93 (95% CI 1.01, 3.66), P = 0.046), incomplete vaccination (AOR = 3.11 (95% CI
1.31, 7.35), P = 0.010), and nutritional stunting (AOR = 0.26 (95% CI 0.13, 0.52); P < 0.0001) were
significantly associated with FN.For the all-cause mortality, serum creatinine > 1mg/dl (AOR = 3.13
(95% CI 1.13, 8.62), P = 0.028), blood urea nitrogen > 20mg/dl (AOR = 1.69 (95% CI 1.01, 2.84), P
= 0.046), low hemoglobin level (AOR = 1.88 (95% CI 1.10, 3.21) P = 0.020), tumor metastasis
(AOR = 2.038 (95%CI 1.16, 3.57), P = 0.013) and history of urinary catheterization (AOR = 1.76
(95%CI 1.01, 3.07), P = 0.046) were significantly associated with mortality.
Conclusion: In this study, a significant number of patients had developed FN and died. Several
tumor and patient related factors were associated with increased risk for the development of FN and
mortality. Therefore, oncologists should improve the evaluation of baseline patient clinical and
performance status before initiating cytotoxic chemotherapy.
