Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update.

Lehrnbecher, Thomas; Robinson, Paula; Fisher, Brian; Alexander, Sarah; Ammann, Roland; Beauchemin, Melissa; Carlesse, Fabianne; Groll, Andreas H; Haeusler, Gabrielle M; Santolaya, Maria; Steinbach, William J; Castagnola, Elio; Davis, Bonnie L; Dupuis, L Lee; Gaur, Aditya H; Tissing, Wim J E; Zaoutis, Theo; Phillips, Robert; Sung, Lillian (2017). Guideline for the Management of Fever and Neutropenia in Children With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: 2017 Update. Journal of clinical oncology, 35(18), pp. 2082-2094. American Society of Clinical Oncology 10.1200/JCO.2016.71.7017

[img] Text
2017.05 xxx JCO Lehrnbecher FN Review.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (616kB) | Request a copy

Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies. For questions of therapy, we conducted a systematic review of randomized trials of any intervention applied for the empirical management of pediatric FN. The Grading of Recommendation Assessment, Development and Evaluation approach was used to make strong or weak recommendations and to classify levels of evidence as high, moderate, low, or very low. Results Recommendations related to initial presentation, ongoing management, and empirical antifungal therapy of pediatric FN were reviewed; the most substantial changes were related to empirical antifungal therapy. Key differences from our 2012 FN CPG included the listing of a fourth-generation cephalosporin for empirical therapy in high-risk FN, refinement of risk stratification to define patients with high-risk invasive fungal disease (IFD), changes in recommended biomarkers and radiologic investigations for the evaluation of IFD in prolonged FN, and a weak recommendation to withhold empirical antifungal therapy in IFD low-risk patients with prolonged FN. Conclusion Changes to the updated FN CPG recommendations will likely influence the care of pediatric patients with cancer and those undergoing hematopoietic stem-cell transplantation. Future work should focus on closing research gaps and on identifying ways to facilitate implementation and adaptation.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Haematology/Oncology

UniBE Contributor:

Ammann, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0732-183X

Publisher:

American Society of Clinical Oncology

Language:

English

Submitter:

Roland Ammann

Date Deposited:

20 Feb 2018 10:16

Last Modified:

20 Feb 2018 10:16

Publisher DOI:

10.1200/JCO.2016.71.7017

PubMed ID:

28459614

BORIS DOI:

10.7892/boris.111124

URI:

https://boris.unibe.ch/id/eprint/111124

Actions (login required)

Edit item Edit item
Provide Feedback