Integrating traditional Chinese medicine in managing neutropenic fever during chemotherapy for pediatric lymphoma: A case report

Background

Neutropenic fever (NF) is a critical complication in pediatric oncology patients undergoing chemotherapy. While Western medicine provides standardized management, the role of Traditional Chinese Medicine (TCM) as an adjunctive therapy in pediatric cases remains underexplored.

Case Presentation

We report the case of a 14-year-old female diagnosed with diffuse large B-cell lymphoma (DLBCL) who developed persistent NF following chemotherapy. Despite broad-spectrum antimicrobial therapy, her fever remained high, reaching 42.2 °C with a WBC count of 70/µL. Given concerns over liver function abnormalities (AST/ALT = 70/229 IU/L) and chemotherapy-related side effects, adjunctive TCM treatment was initiated. The treatment strategy evolved through different therapeutic phases, including resolving dampness and supporting gastrointestinal and hepatic functions, followed by alleviating heat with Sweet-Warm Approach—a TCM method aimed at dispelling Yin Fire—and later a strategy transitioned to a treatment strategy focusing on regulating lung Qi to relieve respiratory symptoms. Clinical improvements were observed, with liver function normalization on July 12^th (AST/ALT = 23/26 IU/L) and eventual resolution of fever.

Conclusion

This case highlights the potential role of TCM as a complementary approach in managing chemotherapy-related complications in pediatric patients. The tailored use of TCM strategies may offer additional benefits in supporting immune function and alleviating systemic imbalances in NF. Further studies are warranted to explore its broader application in pediatric oncology.