Lower uric acid and adequate hydration are associated with lower risk of febrile neutropenia following autologous bone marrow transplantation in patients with lymphoma

Abstract

Background. Despite promising results of autologous bone marrow transplantation (BMT) in patients with lymphoma, infectious complications limit its positive outcomes. This study evaluated the incidence and associated factors of the occurrence of febrile neutropenia (FN) following BMT in patients with lymphoma. Material and methods. Overall, 147  lymphoma patients who were candidates for BMT were consecutively included. Clinical and laboratory results were recorded, and after BMT, the occurrence of FN was investigated through the daily evaluation of neutrophil count and body temperature. Results. FN occurred in 91 patients (61.9 %) on average after 12.77 ± 2.45 days after BMT.  Lower fluid balance was associated with a higher risk of FN (lowest adjusted odds ratio [OR] at day -2 = 0.602, 95% confidence interval [CI] = 0.299 – 0.870, p value = 0.007). The higher uric acid level was associated with a higher risk of FN (highest adjusted OR at day -10 = 1.617, 95% CI = 1.328 – 1.963, p value = 0.035). LDH also had a positive relationship with FN (highest adjusted OR at day 0 = 1.501, 95% CI = 1.198 – 2.104, p value = 0.004). Conclusion. Adequate hydration of the patients is of paramount importance for preventing FN in patients who receive BMT. Furthermore, uric acid and LDH could be considered in future studies for risk stratification of FN.