Febrile Neutropenia
Disease Pathophysiology
The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients.
Klastersky J, Paesmans M, Rubenstein EB, et al.
J Clin Oncol. 2000;18:3038-3051.
Description: A prospective international study to determine valid factors of risk assessment in febrile neutropenic patients with underlying malignancy to then develop a standard, numeric risk index. This index accurately identified those patients at low risk of complications and is employed in treatment algorithms.
PubMed citation number: 10944139
Treatment
Therapeutic use of granulocyte and granulocyte-macrophage colony-stimulating factors in febrile neutropenic cancer patients: a systematic review of the literature with meta-analysis.
Berghmans T, Paesmans M, Lafitte JJ, et al.
Support Care Cancer. 2002;10:181-188.
Description: Compilation of data from 11 prospective randomized trials evaluating the efficacy of colony-stimulating factors in treating febrile neutropenia with respect to mortality, length of hospitalization, duration of fever and neutropenia, antibiotic duration, and toxicity. Results did not lead to the recommendation of the routine use G-CSF or GM-SCF in this patient population.
PubMed citation number: 11904782
Once-per-cycle pegfilgrastim (Neulasta) for the management of chemotherapy-induced neutropenia.
Crawford J.
Semin Oncol. 2003;30:24-30.
Description: Results of randomized, controlled clinical trials in adult patients with different tumor types who all received myelosuppressive chemotherapy revealed pegfilgrastim had a similar safety profile, effect on neutrophil recovery, and reduction in neutropenic complications as filgrastim.
PubMed citation number: 14508717
2002 guidelines for the use of antimicrobial agents in neutropenic patients with cancer.
Hughes WT, Armstrong D, Bodey GP, et al.
Clin Infect Dis. 2002;34:730-751.
Description: Guidelines from the Infectious Disease Society for initial evaluation, algorithm for choosing antimicrobial agents, or adjusting treatment and duration of therapy in neutropenic patients with an underlying malignancy and fever of unknown origin.
PubMed citation number: 11850858
A prospective randomized evaluation of G-CSF or G-CSF plus oral antibiotics in chemotherapy-treated patients at high risk of developing febrile neutropenia.
Lalami Y, Paesmans M, Aoun M, et al.
Support Care Cancer. 2004;12:725-730.
Description: This prospective, randomized control trial comparing the efficacy of G-CSF versus a combination of G-CSF and oral antibiotics in the prevention of febrile neutropenia found G-CSF to be effective, but with little added benefit provided by the antibiotics.
PubMed citation number: 15235901
Evolving concepts of management of febrile neutropenia in children with cancer.
Orudjev E, Lange BJ.
Med Pediatr Oncol. 2002;39:77-85.
Description: Prospective trials and reviews of children with febrile neutropenia defined low-risk patients and found short inpatient treatment with parenteral or oral antibiotics or outpatient parenteral treatment revealed rare life-threatening or fatal infections, but management was changed in 25% either with therapy modification or hospitalization.
PubMed citation number: 12116054
2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines.
Ozer H, Armitage JO, Bennett CL, et al.
American Society of Clinical Oncology Growth Factors Expert Panel. J Clin Oncol. 2000;18:3558-3585. Description: Analysis of published data and recommendations made by committee from the American Society of Clinical Oncology regarding the use of hematopoietic colony-stimulating factors in oncology patients. PubMed citation number: 11032599
Oral versus intravenous antibiotic treatment for febrile neutropenia in cancer patients.
Vidal L, Paul M, Ben-Dor I, Pokroy E, Soares-Weiser K, Leibovici L.
Cochrane Database Syst Rev. 2004:CD003992.
Description: Review of 15 randomized control trials comparing oral versus parenteral antibiotics in febrile neutropenic oncology patients found oral therapy had similar mortality rates and treatment failures to parenteral treatment.
PubMed citation number: 15495074
Empirical antifungal therapy in treating febrile neutropenic patients.
Wingard JR.
Clin Infect Dis. 2004;39:S38-S43.
Description: Discussion of the risks and benefits associated with empiric antifungal therapy in febrile neutropenic patients, concluding there is a need for better diagnostic tools to stratify patient risk of fungemia.
PubMed citation number: 15250019
Systemic antifungal therapy: new options, new challenges.
Wong-Beringer A, Kriengkauykiat J.
Pharmacotherapy. 2003;23:1441-1462.
Description: Comparison of systemic antifungal agents including pharmacology, clinical experience, costs, most common indications for use, and treatment recommendations.
PubMed citation number: 14620391
Review
Congenital neutropenia: advances in diagnosis and treatment.
Badolato R, Fontana S, Notarangelo LD, Savoldi G.
Curr Opin Allergy Clin Immunol. 2004;4:513-521.
Description: Description of multiple of disorders associated with congenital neutropenia, including the underlying pathology, diagnostic approaches, and various treatment options available.
PubMed citation number: 15640692
Febrile neutropenia: past, present and future.
Neth O, Klein N.
Adv Exp Med Biol. 2004;549:119-124.
Description: Historic review over 40 years of the advances in management of febrile neutropenia in oncology patients, including changes in pathogens, susceptibility, and therapy.
PubMed citation number: 15250524
Fever in immunocompromised patients.
Pizzo PA.
N Engl J Med. 1999;341:893-900.
Description: Review of fever in different immunocompromised patient populations (cancer, transplant, splenectomy, HIV/AIDS), including infection risk factors, predominant infectious etiologies of fever, appropriate initial evaluation, and treatment recommendations.
PubMed citation number: 10486422
Perspectives for the management of febrile neutropenic patients with cancer in the 21st century.
Sipsas NV, Bodey GP, Kontoyiannis DP.
Cancer. 2005;103:1103-1113.
Description: Overview of febrile neutropenia with discussion of bacterial pathogens, antibiotic resistance, evaluation, risk assessment, and management based on risk category.
PubMed citation number: 15666328