Clinical Characteristics, Associated Factors, And Treatment Outcomes of Pediatric Cancers at Pediatric Oncology Ward Of Jimma Medical Center, South West Ethiopia

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.