Evaluation of the impact of neutrophil and platelet counts and the neutrophil:platelet ratio on the risk of sepsis in patients with post-chemotherapy neutropenia

• Grant number: 23/04541-8
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2024
• End date: January 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Erich Vinicius de Paula
• Grantee: Gabriela Romantini Salioni
• Host Institution: Centro de Hematologia e Hemoterapia (HEMOCENTRO). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Febrile neutropenia (FN) frequently occurs after chemotherapy for hematological malignancies and is a potentially serious complication in this group of patients, as it increases the risk of septic shock. Despite advances in supportive care, gaps remain in our knowledge about the pathophysiology of sepsis complications in the context of FN. Furthermore, the association between neutropenia and mortality is controversial in cancer patients, not being known in the subgroup of patients with hematologic malignancies. Data obtained from animal models and translational studies indicate that platelets and neutrophils act both in defense against pathogens and in the mediation of secondary tissue injury, by promoting the formation of neutrophil extracellular traps (NETs). In this context, it is interesting to explore the effect of the marked neutropenia and thrombocytopenia observed in patients after chemotherapy for hematologic malignancies with regard to the risk of sepsis complications, as well as their clinical characteristics. The aim of this project is to evaluate the association between neutrophil and platelet counts, and especially the neutrophil:platelet ratio, with relevant sepsis outcomes in these patients. This will be done by analyzing the clinical data of all patients with FN assisted by the Hemocentro Unicamp hematology team at the Hospital das Clínicas of this institution between 2018 and 2021. The inclusion criteria will be the diagnosis of hematological neoplasia registered at the Hemocentro Unicamp and the neutrophil count < 500/mm3 in a blood count performed during hospitalization at HC-Unicamp between 2018 and 2021. The exclusion criteria will be the absence of a fever record during hospitalization and the absence of data in the electronic system that would allow the case to be characterized in terms of the inclusion criteria. The data will be identified from the laboratory and anonymized prior to analyses. The primary endpoint will be infection-related death during admission, and the secondary endpoints will cover organ-specific injury.