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45. Febrile Neutropenia

Historical perspective

Bodey GP, Buckley M, Sathe YS, Freireich EJ.

Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia.
Annals of Internal Medicine. 64(2): 328-40 (1966)
Description: This study was the first to recognize the association of neutropenia and risk of serious infection in patients with cancer receiving cytotoxic chemotherapy.
PubMed citation number: 5216294

Hathorn JW and Lyke K.

Empirical treatment of febrile neutropenia: evolution of current therapeutic approaches.
Clinical Infectious Diseases. 24 Suppl 2: S256-65 (1997)
Description: This article traces the origins of current therapeutic approaches in febrile neutropenia. It reviews the various strategies for therapy developed to keep up with the changing epidemiology of infectious organisms, emergence of drug resistant strains and increasing variety of therapeutic options.
PubMed citation number: 9126701

Review articles

Pizzo PA.

Fever in immunocompromised patients.
New England Journal of Medicine. 341(12): 893-900 (1999)
Description: This paper reviews the specific challenges in the management of fever in the immunocompromised patient.
PubMed citation number: 10486422

Crawford J, Dale DC, Lyman GH.

Chemotherapy-induced neutropenia: risks, consequences, and new directions for its management.
Cancer. 100(2): 228-37 ( 2004)
Description: This article reviews the epidemiology and risk factors for neutropenic complications, its consequences and costs in patients receiving chemotherapy.
PubMed citation number: 14716755

Risk assessment

Talcott JA, Finberg R, Mayer RJ, Goldman L.

The medical course of cancer patients with fever and neutropenia. Clinical identification of a low-risk subgroup at presentation.
Archives of Internal Medicine. 148(12): 2561-8 (1988)
Description: This is one of the early articles that sought to classify patients into risk groups based on clinical characteristics at the time of presentation with febrile neutropenia.
PubMed citation number: 3196123

Klastersky J, Paesmans M, Rubenstein EB, Boyer M, Elting L, Feld R, Gallagher J, Herrstedt J, Rapoport B, Rolston K, Talcott J.

The Multinational Association for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients.
Journal of Clinical Oncology. 18(16): 3038-51 (2000)
Description: This article establishes and validates a scoring system to identify patients, at the time of presentation with febrile neutropenia, who are at a low risk of complications.
PubMed citation number: 10944139

Management guidelines

Hughes WT, Armstrong D, Bodey GP, Bow EJ, Brown AE, Calandra T, Feld R, Pizzo PA, Rolston KV, Shenep JL, Young LS.

2002 Guidelines for the use of antimicrobial agents in neutropenic patients with cancer.
Clin Infect Dis 34: 730 51 (2002)
Description: This article presents updated guidelines prepared by the Infectious Diseases Society of America (IDSA) Fever and Neutropenia Guidelines Panel, for the treatment of neutropenic patients with unexplained fever.
PubMed citation number: 11850858

Ozer H, Armitage JO, Bennett CL, Crawford J, Demetri GD, Pizzo PA, Schiffer CA, Smith TJ, Somlo G, Wade JC, Wade JL 3rd, Winn RJ, Wozniak AJ, Somerfield MR.

American Society of Clinical Oncology. 2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. American Society of Clinical Oncology Growth Factors Expert Panel.
Journal of Clinical Oncology. 18(20): 3558-85 ( 2000)
Description: This article presents evidence-based clinical practice guidelines for the use of hematopoietic colony stimulating factors developed by the American Society of Clinical Oncology (ASCO) expert panel. Please watch for updated guidelines by the ASCO expert panel, expected to be published in late 2004.
PubMed citation number: 11032599

Focus on pediatrics

Orudjev E and Lange BJ.

Evolving concepts of management of febrile neutropenia in children with cancer.
Medical & Pediatric Oncology 39(2): 77-85 (2002)
Description: This is a review of recent risk assessment models and prospective trials in children. The authors propose an evidence-based algorithm for the management of children with febrile neutropenia.
PubMed citation number: 12116054

Levine JE and Boxer LA.

Clinical applications of hematopoietic growth factors in pediatric oncology.
Current Opinion in Hematology. 9(3): 222-7 ( 2002)
Description: This article reviews the use of G-CSF and GM-CSF in pediatric oncology.
PubMed citation number: 11953668

Economics

Lyman GH and Kuderer NM
.
The economics of the colony-stimulating factors in the prevention and treatment of febrile neutropenia.
Critical Reviews in Oncology / Hematology 50: 129- 146 (2004)
Description: This review explains the economic models based on measures of resource utilization that are derived from randomized clinical trials of patients with febrile neutropenia, and the impact of the use of colony stimulating factors in both prophylactic and therapeutic settings.
PubMed citation number: 15157662

Novel therapies

Wong-Beringer A and Kriengkauykiat J.

Systemic antifungal therapy: new options, new challenges.
Pharmacotherapy 23(11): 1441-62 (2003)
Description: This article compares the pharmacologic characteristics, efficacy, toxicity and costs of systemic antifungal agents with emphasis on new agents with recommendations for use in invasive candidiasis, invasive aspergillosis and febrile neutropenia.
PubMed citation number: 14620391

Crawford J.

Once-per-cycle pegfilgrastim (Neulasta) for the management of chemotherapy-induced neutropenia.
Seminars in Oncology 30(4 Suppl 13):24-30 ( 2003)
Description: This article reviews available data on pegfilgastrim, which is a longer acting, self-regulating form of G-CSF that can be administered once per chemotherapy cycle.
PubMed citation number: 14508717

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