Prognosis

Although mortality from febrile neutropenia has steadily declined, the condition is still associated with considerable morbidity and mortality. Approximately 20% to 30% of patients with febrile neutropenia present with complications that require in-hospital management.[20] A retrospective study of cancer patients hospitalised with febrile neutropenia found an overall in-patient mortality of 9.5%.[17]

Length of hospital stay and complications for high-risk patients

Length of hospital stay differs between studies, but average length of stay has been reported to be up to 10 days in patients admitted for febrile neutropenia.[119][120][121]​​

Length of hospital stay and complications from febrile neutropenia are associated with age >65 years, advanced stage of disease, duration and magnitude of neutropenia, pre-existing organ dysfunction and comorbid conditions, impaired performance status, and low serum albumin.[6][48]

Patients who present with hypotension, documented bloodstream infection, or pneumonia are at increased risk for complications and death.[122][123][124][125][126][127]

Risk for recurrent febrile neutropenia

Patients with a history of febrile neutropenia are at risk for subsequent episodes of febrile neutropenia.

If a patient developed febrile neutropenia during a prior cycle of chemotherapy and granulocyte colony-stimulating factor (G-CSF) prophylaxis was not used, then G-CSF prophylaxis should be considered for use with subsequent cycles of chemotherapy.[45][57][58]​​​ Risk assessment for febrile neutropenia should be carried out after each cycle of chemotherapy.

Sargramostim, a granulocyte-macrophage colony-stimulating factor (GM-CSF), is primarily used for the treatment of febrile neutropenia and prophylactic use is not recommended.[45]

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