Fever and Neutropenia Can Be a Risk to the Child ’s Life

Lee and colleagues report a 39.4% rate of grade 3 or 4 neutropenia following 171 cycles of intra-arterial chemotherapy (IAC) administered to 49 patients with retinoblastoma. The most recent version of the Common Terminology Criteria for Adverse Events (CTCAE) classifies grade 3 neutropenia as an absolute neutrophil count of 500 to less than 1000 and grade 4 as an absolute neutrophil count of less than 500. Most cycles (72%) in this retrospective single-institution case series used triple drug therapy with melphalan, topotecan, and carboplatin. Multivariate regression analysis showed more grade 3 or 4 neutropenia with higher melphalan and topotecan doses.
Source: JAMA Ophthalmology - Category: Opthalmology Source Type: research