Neutropenia and fever precipitated from the state are very common and fatal problems to the patients with hematologic malignancy, especially acute leukemia. Additionally, febrile neutropenia costs a lot of money, because the patients generally need to be admitted to hospitals and treated by lots of medications like antibiotics and antifungal drugs. This study was designed to find out the factors that can decrease the duration of febrile neutropenia in acute myeloid leukemia patients and focused the impact due to early (i.e. less than 3 weeks) removal of the central venous catheter that inserted to most of acute myeloid leukemia patients receiving chemotherapy.
This retrospective study in a single center analyzed the effects of age, gender, body mass index(BMI), type of chemotherapy, presence of baseline fever before chemotherapy, presence of blood stream infection (BSI), insertion site of central venous catheter and early removal of central venous catheter on the duration of fever in acute myeloid leukemia patients with febrile neutropenia. The results were significant in both univariate and multivariate analyses depending on age, type of chemotherapy, presence of baseline fever and especially, early removal of central venous catheter (univariate analysis: p=0.001, multivariate analysis: hazard ratio 0.546, 95% confidence interval 0.368-0.810, p=0.003).
So, the physicians treating febrile neutropenic patients with acute myeloid leukemia may need to actively consider early removal of central venous catheter for reducing the duration of febrile neutropenia.