Risk factors related to infection in pediatric patients with cancer and febrile neutropenia induced by chemotherapy – a systematic review.

Resumo

Background -  Febrile neutropenia induced by chemotherapy is the major risk factor for infection and death in cancer patients. The identification of these risk factors must take into consideration the heterogeneity of this population. Objective - to perform a systematic review of the studies addressing the risk factors related to infection among pediatric patients with cancer and febrile neutropenia and their epidemiological characteristics. Contents - The characteristics considered for selecting the articles were: population, exposition, comparison, outcome according to the acronym PECOS. The definition was as follows: P, patients under 18 years of age with febrile neutropenia induced by chemotherapy, E: presence of risk factors besides neutropenia; C no risk factors besides neutropenia; O, infection and S, original studies. The search was carried out using the PubMed, Virtual Health Library (Scielo, LILACs, and MEDLINE) and EMBASE. Sixty-three observational studies were included, and The Critical Appraisal Skills Programme (CASP) was used to evaluate the methods and descriptions of observational studies. 46 variables with potential relationship with infection were identified. Type of cancer (44% of the studies), fever degree (30%), absolute neutrophil count (30%), platelets (30%) and C-reactive protein (30%) were the five most studied variables. Conclusion - This review identified current risk factors related to bacteremia in pediatric patients with cancer and febrile neutropenia.