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Drug fever after cancer chemotherapy is most commonly observed on posttreatment days 3 and 4

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Abstract

Background

This study was undertaken to analyze the characteristics of fever after cancer chemotherapy in order to reduce unnecessary medical care.

Methods

Retrospectively, 1016 consecutive cycles of cancer chemotherapy were analyzed. Fever was defined as a temperature of ≥37.5 °C lasting for 1 h. Age, sex, tumor histology, the treatment regimen, the timing of fever onset, the number of days for which the fever persisted, the cause of the fever, the presence or absence of radiotherapy, and the use of granulocyte colony-stimulating factor (G-CSF) were examined.

Results

The patients included 748 males and 268 females (median age = 68, range = 29–88), of whom 949, 52, and 15 were suffering from lung cancer, malignant pleural mesothelioma, and other diseases, respectively. Fever was observed in 367 cycles (36 %), including 280 cycles (37 %) involving males and 87 cycles (32 %) involving females. Fever occurred most commonly in the first cycles and was higher than later cycles (41 vs. 30 %, p < 0.001). Fever occurred most frequently on posttreatment days 4 (8 %), 3 (7 %), and 12 (7 %), and the distribution of fever episodes exhibited two peaks on posttreatment days 3 and 4 and 10–14. Fever on posttreatment days 3 and 4 was most commonly observed in patients treated with gemcitabine (20 %) or docetaxel (18 %). The causes of fever included infection (47 %; including febrile neutropenia [24 %]), adverse drug effects (24 %), unknown causes (19 %), and tumors (7 %). Radiotherapy led to a significant increase in the frequency of fever (46 vs. 34 %, p < 0.001). Thirty-three percent of patients received G-CSF, and the incidence ratios of fever in patients who received G-CSF were higher than those who did not receive G-CSF (44 vs. 31 %, p < 0.001).

Conclusion

The febrile episodes that occurred on posttreatment days 3 and 4 were considered to represent adverse drug reactions after cancer chemotherapy. Physicians should be aware of this feature of chemotherapy-associated fever and avoid unnecessary examination and treatments including prescribing antibiotics.

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Conflict of interest

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan

    Daiki Ogawara, Minoru Fukuda, Shinnosuke Takemoto, Kosuke Mizoguchi, Katsumi Nakatomi, Yoichi Nakamura, Yasushi Obase & Shigeru Kohno

  2. Clinical Oncology Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Minoru Fukuda, Takuya Honda & Kazuto Ashizawa

  3. Department of Respiratory Medicine, Ikeda Hospital, Kagoshima, Japan

    Shiro Ueno

  4. Department of Respiratory Medicine, Kawasaki Medical School, Okayama, Japan

    Yoshihiro Ohue & Mikio Oka

  5. Department of Pharmacotherapeutics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

    Kazuhiro Tsukamoto

Authors
  1. Daiki Ogawara
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  2. Minoru Fukuda
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  3. Shiro Ueno
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  4. Yoshihiro Ohue
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  5. Shinnosuke Takemoto
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  6. Kosuke Mizoguchi
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  7. Katsumi Nakatomi
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  8. Yoichi Nakamura
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  9. Yasushi Obase
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  10. Takuya Honda
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  11. Kazuhiro Tsukamoto
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  12. Kazuto Ashizawa
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  13. Mikio Oka
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  14. Shigeru Kohno
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Corresponding author

Correspondence to Minoru Fukuda.

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Ogawara, D., Fukuda, M., Ueno, S. et al. Drug fever after cancer chemotherapy is most commonly observed on posttreatment days 3 and 4. Support Care Cancer 24, 615–619 (2016). https://doi.org/10.1007/s00520-015-2820-8

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  • DOI: https://doi.org/10.1007/s00520-015-2820-8

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