Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting
PURPOSESepsis is the main cause of nonrelapse mortality, and there are no published data on applicability of supportive care protocols from high-income countries such as Sri Lanka. The aim of the study was to investigate management and mortality of neutropenic episodes among Hemato-Oncology patients...
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2024-03-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.23.00412 |
| _version_ | 1827317988721688576 |
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| author | Saman Hewamana Thurairajah Skandarajah Chathuri Jayasinghe Samadhi Deshapriya Dilip Gayashan Natasha Peiris Mahesh Harischandra Prasanna Gunasena Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Chandana Wickramarathna Sangeetha Hewawasam Jayantha Balawardena Gehan Arseculeratne Rohini Wadanamby Geethani Galagoda Bandula Wijesiriwardana |
| author_facet | Saman Hewamana Thurairajah Skandarajah Chathuri Jayasinghe Samadhi Deshapriya Dilip Gayashan Natasha Peiris Mahesh Harischandra Prasanna Gunasena Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Chandana Wickramarathna Sangeetha Hewawasam Jayantha Balawardena Gehan Arseculeratne Rohini Wadanamby Geethani Galagoda Bandula Wijesiriwardana |
| author_sort | Saman Hewamana |
| collection | DOAJ |
| description | PURPOSESepsis is the main cause of nonrelapse mortality, and there are no published data on applicability of supportive care protocols from high-income countries such as Sri Lanka. The aim of the study was to investigate management and mortality of neutropenic episodes among Hemato-Oncology patients.MATERIALS AND METHODSRetrospective analysis of clinical characteristics, management, morbidity, and mortality of neutropenic Hemato-Oncology patients presented to the Lanka Hospital Blood Cancer Centre from January 1, 2019 to December 31, 2019 was performed.RESULTSA total of 169 neutropenic episodes were identified; 115 (68%) of such episodes were related to chemotherapy. Acute leukemia, lymphoproliferative disorders, and plasma cell disorders accounted for 23%, 69%, and 8% of patients, respectively. The median age of patients who had sepsis was 56 years, whereas that of those who had no sepsis was 53 years (P = .49). The median time to neutropenia was 9 days for those in the sepsis group compared with 8 days in the group that had no sepsis (0.64). The median neutrophil count in the group that had sepsis was 0.06, whereas it was 0.69 in the group that had no sepsis (P ≤ .05). The median time to commencement of antibiotics was 20 minutes.CONCLUSIONTo our knowledge, this is the only documented study related to outcome and successful applicability of western supportive care protocols to Sri Lankan patients with neutropenia. In this study, we have shown that neutropenic sepsis can be successfully managed in the setting of limited resources with service development, following guidelines and staff training. |
| first_indexed | 2024-04-24T23:50:00Z |
| format | Article |
| id | doaj.art-a2e7e59634d246cd8b39ff244916e165 |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-04-24T23:50:00Z |
| publishDate | 2024-03-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-a2e7e59634d246cd8b39ff244916e1652024-03-14T19:59:28ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-03-011010.1200/GO.23.00412Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited SettingSaman Hewamana0Thurairajah Skandarajah1Chathuri Jayasinghe2Samadhi Deshapriya3Dilip Gayashan4Natasha Peiris5Mahesh Harischandra6Prasanna Gunasena7Gnani Somasundaram8Vadivelu Srinivasan9Surjit Somiah10Chandana Wickramarathna11Sangeetha Hewawasam12Jayantha Balawardena13Gehan Arseculeratne14Rohini Wadanamby15Geethani Galagoda16Bandula Wijesiriwardana17Lanka Hospital, Colombo, Sri LankaNational Cancer Institute, Colombo, Sri LankaDepartment of Statistics, University of Sri Jayewardenepura, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital Diagnostics, Colombo, Sri LankaAsiri Surgical Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaFaculty of Medicine, University of Ruhuna, Matara, Sri LankaLanka Hospital, Colombo, Sri LankaSir John Kotelawala Defence University, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaLanka Hospital Diagnostics, Colombo, Sri LankaLanka Hospital Diagnostics, Colombo, Sri LankaLanka Hospital, Colombo, Sri LankaPURPOSESepsis is the main cause of nonrelapse mortality, and there are no published data on applicability of supportive care protocols from high-income countries such as Sri Lanka. The aim of the study was to investigate management and mortality of neutropenic episodes among Hemato-Oncology patients.MATERIALS AND METHODSRetrospective analysis of clinical characteristics, management, morbidity, and mortality of neutropenic Hemato-Oncology patients presented to the Lanka Hospital Blood Cancer Centre from January 1, 2019 to December 31, 2019 was performed.RESULTSA total of 169 neutropenic episodes were identified; 115 (68%) of such episodes were related to chemotherapy. Acute leukemia, lymphoproliferative disorders, and plasma cell disorders accounted for 23%, 69%, and 8% of patients, respectively. The median age of patients who had sepsis was 56 years, whereas that of those who had no sepsis was 53 years (P = .49). The median time to neutropenia was 9 days for those in the sepsis group compared with 8 days in the group that had no sepsis (0.64). The median neutrophil count in the group that had sepsis was 0.06, whereas it was 0.69 in the group that had no sepsis (P ≤ .05). The median time to commencement of antibiotics was 20 minutes.CONCLUSIONTo our knowledge, this is the only documented study related to outcome and successful applicability of western supportive care protocols to Sri Lankan patients with neutropenia. In this study, we have shown that neutropenic sepsis can be successfully managed in the setting of limited resources with service development, following guidelines and staff training.https://ascopubs.org/doi/10.1200/GO.23.00412 |
| spellingShingle | Saman Hewamana Thurairajah Skandarajah Chathuri Jayasinghe Samadhi Deshapriya Dilip Gayashan Natasha Peiris Mahesh Harischandra Prasanna Gunasena Gnani Somasundaram Vadivelu Srinivasan Surjit Somiah Chandana Wickramarathna Sangeetha Hewawasam Jayantha Balawardena Gehan Arseculeratne Rohini Wadanamby Geethani Galagoda Bandula Wijesiriwardana Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting JCO Global Oncology |
| title | Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting |
| title_full | Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting |
| title_fullStr | Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting |
| title_full_unstemmed | Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting |
| title_short | Successful Management of Neutropenic Sepsis Is Key to Better Survival of Patients With Blood Cancer in Sri Lanka: Real-World Data From the Resource-Limited Setting |
| title_sort | successful management of neutropenic sepsis is key to better survival of patients with blood cancer in sri lanka real world data from the resource limited setting |
| url | https://ascopubs.org/doi/10.1200/GO.23.00412 |
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