Causes of Death in Febrile Granulocytopenic Cancer Patients Receiving Empiric Antibiotic Therapy

We reviewed the causes of death of 55 granulocytopenic patients who received empiric antibiotic treatment for fever according to an EORTC cooperative protocol; 53 presented cancer and 2 aplastic anemia. Among the 55 patients, 19 (35%) deaths were attributed to infection: 16 to bacterial and 3 to fungal infections. Among the patients with bacterial infections, 12 died from septic shock, 3 from pneumonia and 1 from Pseudomonas aeruginosa meningitis. The most frequent non-infectious causes of death were the cancer progression (18%) and hemorrhagic complications (27%), most often cerebromeningeal in relationship to thrombocytopenia. A large number of the patients who died from infection (78%) and hemorrhage (74%) had advanced cancer with poor chances to respond to anticancer therapy.