Senior Resident, Department of Paediatric Oncology, Government Medical College and Cancer Hospital, Chhatrapati Sambhajinagar, Maharashtra, India.

Introduction: Febrile neutropenia is a dreaded complication in the treatment of acute leukemia in children.This medical emergency is more common in the intensive chemotherapy phases. Objectives:In this study,we aimed to determine the epidemiological,clinical,and microbiological characteristics of such episodes in pediatric patients with acute leukemia started on induction chemotherapy.Materials And Methods: Seventy two episodes of febrile neutropenia in 63 children (34 females and 29 males) were included in the study. All of the episodes were treated at a tertiary cancer center of Maharashtra,India from January 1,2023 to December 31,2024. Results:The febrile neutropenia episodes had an equal gender predilection with a mean age of 6.8 ± 3.7 years.B-acute lymphoblastic leukemia (79.1%) was the most common phenotype and high risk was the most common risk group. The upper respiratory tract was the most common focus (34.7%) identified.The mean duration of the episodes was 5.7 ± 3.9 days.The mean absolute neutrophil count was 259 ± 3 150 per mm and 19.4% of cases had profound neutropenia.We found that 41.7% of episodes had culture positivity with Methicillin-Resistant Staphylococcus aureus (MRSA) as the most common organism isolated. The mean antibiotic duration was 11.5 +/- 5.0 days—with aminoglycosides being used in two-thirds of the episodes.Antifungals were used in 29.2% of episodes.Patients survived in 91.7% of the episodes,with sepsis the leading cause of mortality in 50% of cases. Conclusions: Key drivers for the decrement of febrile neutropenia-related morbidity and mortality include proper precautions, close monitoring, risk factor identification, the rapid empirical use of antibiotics, and the timely modification of treatment.