Chemotherapy-induced febrile neutropenia in acute myeloblastic leukemia: A single- center study of adult patients

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Published Apr 12, 2026
https://doi.org/10.62438/tunismed.v104i03.6189
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Vol. 104 No. 03 (2026): Tunis Med Mar 2026

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Hela Sahbani
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Hend Ben Neji
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Rachid Kharrat
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Rabeb Berred
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Manel Bchir
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Manel Hamdoun
Microbiology-Biochemistry Laboratory, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Olfa Bahri
Microbiology-Biochemistry Laboratory, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia
Raihane Ben Lakhal
Department of clinical hematology, Aziza Othmana Hospital, Faculty of Medicine of Tunis,University of Tunis El Manar, 1007, Tunis, Tunisia

Abstract

Introduction: Management of febrile neutropenia (FN) depends on several elements. Despite their importance, tunisian data were poor.
Aim: To describe the clinical, microbiological and therapeutic profile of chemotherapy-induced FN during acute myeloblastic leukemia (AML).
Methods: This observational cohort study, conducted in hematology department of Aziza Othmana hospital, included all intensive chemotherapy-induced FN episodes observed in patients aged ≥18 years and diagnosed with AML in 2021. Data were retrospectively collected and descriptively analyzed.
Results : Among 33 patients, 121 FN episodes were studied. They were observed respectively during induction (52.1%), consolidation (38.8%) or salvage therapy (9.1%) cycles. Episodes were labeled as fever ofunknown origin (29.8%), clinically documented infection (51.2%) and microbiologically documented infection (MDI) (19.0%). Clinical infectious sites were skin/soft tissue (44.6%), gastrointestinal tract (27.3%), respiratory tract (27.3%) and otorhinolaryngology tract (5.0%). Gram-positive cocci and Gram-negative bacilli were isolated respectively in 18 and 15 cases, with CoNS and Klebsiella pneumoniae being the commonest. Multidrug-resistant organisms were observed in nine episodes. Extended-spectrum-beta-lactamase was the most common resistance mechanism. An intensive care unit treatment was required in 13 episodes and noted in two episodes. Sepsis was observed in 28.1% of episodes. FN-related mortality was 7.4%, associated with sepsis, pneumonia and MDI.
Conclusion: Better supportive care strategies may improve infectious outcome in AML patients undergoing chemotherapy.

Keywords:

Febrile neutropenia, Chemotherapy, Acute myeloid leukemia, Infections, Anti-microbial agents

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