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Leuk Lymphoma. 2019 Jan 18:1-8. doi: 10.1080/10428194.2018.1538512. [Epub ahead of print]

A randomized controlled feasibility trial of paracetamol during febrile neutropenia in hemato-oncology patients.

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a Wellington Blood and Cancer Centre, Capital and Coast DHB , Wellington , New Zealand.
b Malaghan Institute of Medical Research , Wellington , New Zealand.
c Department of Pathology and Molecular Medicine , University of Otago Wellington , Wellington , New Zealand.
d Institute of Environmental Science and Research , Upper Hutt , New Zealand.
e Department of Medicine , University of Otago Wellington , Wellington , New Zealand.
f Medical Research Institute of New Zealand , Wellington , New Zealand.
g Intensive Care Unit, Capital and Coast District Health Board , Wellington , New Zealand.


The efficacy of paracetamol (acetaminophen) as an antipyretic during febrile neutropenia (FN) has not previously been established. We conducted a randomized double-blind placebo-controlled feasibility trial: hemato-oncology patients at high FN risk were randomly assigned to six hourly oral paracetamol (1 g) or placebo during the first 42 hours of FN. Fifty-three participants were screened, thirty-seven enrolled; 22 developed FN and commenced treatment (13 paracetamol; 9 placebo); recruitment rates were below, and retention rates met, pre-defined feasibility criteria. During the first 24 hours of FN, paracetamol recipients had significantly lower peak temperature than placebo: mean 38.2 (standard deviation 0.8) °C versus 38.9 (0.4) °C; difference -0.78 °C (95% CI -1.38 to -0.18); p = .013. Bacterial load measurement was not informative. Paracetamol lowers body temperature during FN, and definitive trials to determine its impact on FN outcomes are needed. Australian New Zealand Clinical Trials Registry reference ACTRN12613000601730; funded by Health Research Council of New Zealand.


Febrile neutropenia; acetaminophen; antipyretics; fever; neutropenia

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