中性粒细胞减少性发热是肿瘤治疗中最常见的致死性并发症。在欧洲,一个前瞻性多因素风险模型发现了在第一轮化疗中与中性粒细胞减少性发热发生有关的临床相关的预测性或保护性因素,并准确鉴别出了在第一轮化疗中容易出现中性粒细胞减少性发热的较高比例人群。[1]Pettengell R, Bosly A, Szucs TD, et al. Multivariate analysis of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma: data from the INC-EU Prospective Observational European Neutropenia Study. Br J Haematol. 2009;144:677-685.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2680267/?tool=pubmedhttp://www.ncbi.nlm.nih.gov/pubmed/19055662?tool=bestpractice.com 在美国,中性粒细胞减少性发热的发生数预计为一年 60,294 例,相当于每 1000 例癌症患者中就出现 7.83 例。[2]Caggiano V, Weiss RV, Rickert TS, et al. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005;103:1916-1924.http://www3.interscience.wiley.com/cgi-bin/fulltext/109934135/HTMLSTARThttp://www.ncbi.nlm.nih.gov/pubmed/15751024?tool=bestpractice.com 而在接受血液系统恶性肿瘤治疗的患者中,发生率升至每 1000 例患者中有 43.3 例。[2]Caggiano V, Weiss RV, Rickert TS, et al. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005;103:1916-1924.http://www3.interscience.wiley.com/cgi-bin/fulltext/109934135/HTMLSTARThttp://www.ncbi.nlm.nih.gov/pubmed/15751024?tool=bestpractice.com 中性粒细胞减少性发热占接受化疗的实体肿瘤患者死亡原因的 50%。它也占接受化疗的急性白血病患者死亡原因的 70%-75%。若不在最初的 48 小时内治疗,死亡率可达 50%。[3]Bodey GP, Jadeja L, Elting L. Pseudomonas bacteremia. Retrospective analysis of 410 episodes. Arch Intern Med. 1985;145:1621-1629.http://www.ncbi.nlm.nih.gov/pubmed/3927867?tool=bestpractice.com 及时给予抗生素使反应率高达 60%-70%,并降低死亡率至 10%。[4]Schimpff S, Satterlee W, Young VM, et al. Empiric therapy with carbenicillin and gentamicin for febrile patients with cancer and granulocytopenia. N Engl J Med. 1971;284:1061-1065.http://www.ncbi.nlm.nih.gov/pubmed/4994878?tool=bestpractice.com