The Association of Chemotherapy-Induced Neutropenia with the Risk of Febrile Neutropenia and Infections: A Systematic Review
Notice bibliographique
Résumé
INTRODUCTION Chemotherapy-induced neutropenia (CIN) is a primary dose-limiting toxicity of myelosuppressive cancer therapy. It significantly increases a patient's susceptibility to febrile neutropenia (FN), an oncologic emergency associated with severe infections, substantial morbidity, and mortality. This systematic review synthesizes the evidence linking CIN to the risk of FN and subsequent infectious complications. METHODS A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted for studies published from January 2010 onwards, following PRISMA guidelines. Observational studies and clinical trials involving cancer patients receiving chemotherapy and reporting on neutropenic complications were included. Data on over 15 distinct clinical, microbiological, and treatment-related outcomes were extracted. The methodological quality of included studies was appraised using the Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale. RESULTS Twenty studies, encompassing prospective and retrospective cohorts, cross-sectional analyses, and validation studies, met the inclusion criteria. The evidence confirms that CIN is a direct precursor to FN, with an incidence of up to 16.8% per chemotherapy course, and a peak risk during the first treatment cycle. FN frequently necessitates hospitalization, with a mean duration of approximately 8 days, and is associated with significant in-hospital mortality rates ranging from 2.6% to over 25% in high-risk, culture-positive cohorts. Bloodstream infections are the most common severe documented complication. The microbiological landscape is evolving, with a resurgence of Gram-negative pathogens, including multidrug-resistant organisms, challenging standard empiric antibiotic regimens. Neutropenic events directly impact oncologic care, leading to frequent chemotherapy dose reductions and delays, which can compromise treatment efficacy. DISCUSSION The synthesized evidence underscores the profound clinical and economic burden of neutropenic complications. A critical gap exists between guideline recommendations for risk stratification and the poor predictive performance of existing clinical tools like the MASCC and CISNE scores. An episode of FN serves not only as an acute event but also as a sentinel marker of patient vulnerability, predicting a significantly increased long-term risk of subsequent infections. CONCLUSION CIN is unequivocally associated with an elevated risk of FN and life-threatening infections. This relationship drives significant morbidity, mortality, and disruptions to cancer treatment. Future efforts must prioritize the development of dynamic, data-driven risk prediction models and surveillance-informed antimicrobial stewardship to optimize patient management and improve oncologic outcomes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».