Neutropenia: A narrative review

Abstract

Introduction: Neutropenia is one of the most common complications in patients receiving systemic treatment with chemotherapy; this is a heterogeneous population; therefore, its clinical presentation is nonspecific, presenting asymptomatically or even showing very severe symptoms with signs of severe sepsis. Given those above, currently, the working groups need to consistently determine the different risk factors contributing to the presentation of neutropenia to stratify the patient and thus optimally reduce complications.

Important points: This work emphasizes the analysis of risk factors, including the patient, the disease, and the treatment, according to stratification systems such as MASCC and CISNE. In addition, the clinical and microbiological foundations were evaluated to categorize the patient and include prophylactic support measures for the most frail groups, reducing the high risk of severe complications.

Conclusion: Neutropenia is an undesirable adverse event in managing oncohaematological treatment. The MASCC and CISNE risk stratification systems are valuable tools for selecting low-risk patients. However, other factors, such as the type of tumor and infection, may influence the stratification. Therefore, it is essential to manage each patient individually. The initiation of antimicrobial prophylaxis and the use of FECG can help reduce morbidity and mortality.