Guideline for the Management of Fever and Neutropenia in Children With Cancer and/or Undergoing Hematopoietic Stem-Cell Transplantation

被引：256

作者：

Lehrnbecher, Thomas ^{[2
]}

Phillips, Robert ^{[4
,5
]}

Alexander, Sarah

Alvaro, Frank ^{[8
]}

Carlesse, Fabianne ^{[9
]}

Fisher, Brian ^{[10
]}

Hakim, Hana ^{[11
]}

Santolaya, Maria ^{[12
,13
]}

Castagnola, Elio ^{[14
]}

Davis, Bonnie L. ^{[15
]}

Dupuis, L. Lee

Gibson, Faith ^{[6
,7
]}

Groll, Andreas H. ^{[3
]}

Gaur, Aditya ^{[11
]}

Gupta, Ajay ^{[16
,17
]}

Kebudi, Rejin ^{[18
]}

Petrilli, Sergio ^{[9
]}

Steinbach, William J. ^{[19
]}

Villarroel, Milena ^{[12
,13
]}

Zaoutis, Theoklis ^{[10
]}

Sung, Lillian ^{[1
]}

机构：

[1] Hosp Sick Children, Div Haematol Oncol, Toronto, ON M5G 1X8, Canada

[2] Goethe Univ Frankfurt, Frankfurt, Germany

[3] Univ Childrens Hosp Muenster, Munster, Germany

[4] Leeds Gen Infirm, Leeds, W Yorkshire, England

[5] Univ York, York YO10 5DD, N Yorkshire, England

[6] Great Ormond St Hosp Sick Children, London WC1N 3JH, England

[7] London S Bank Univ, London, England

[8] John Hunter Childrens Hosp, Newcastle, NSW, Australia

[9] Univ Fed Sao Paulo, Sao Paulo, Brazil

[10] Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA

[11] St Jude Childrens Res Hosp, Memphis, TN 38105 USA

[12] Hosp Ninos Luis Calvo Mackenna, Santiago, Chile

[13] Univ Chile, Santiago, Chile

[14] Ist Giannina Gaslini, I-16148 Genoa, Italy

[15] High Tor, Nassau, Bahamas

[16] Inst Rotary Canc Hosp, New Delhi, India

[17] All India Inst Med Sci, New Delhi, India

[18] Istanbul Univ, Istanbul, Turkey

[19] Duke Univ, Med Ctr, Durham, NC USA

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2012年 / 30卷 / 35期

基金：

加拿大健康研究院;

关键词：

PEDIATRIC ONCOLOGY PATIENTS; INVASIVE FUNGAL-INFECTIONS; EARLY HOSPITAL DISCHARGE; ROUTINE CHEST RADIOGRAPHY; LIPOSOMAL AMPHOTERICIN-B; ASPERGILLUS GALACTOMANNAN ANTIGEN; CHEMOTHERAPY-INDUCED NEUTROPENIA; EMPIRICAL ANTIBIOTIC-TREATMENT; CLINICAL-PRACTICE GUIDELINES; ACUTE LYMPHOBLASTIC-LEUKEMIA;

D O I：

10.1200/JCO.2012.42.7161

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Purpose To develop an evidence-based guideline for the empiric management of pediatric fever and neutropenia (FN). Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group composed of experts in pediatric oncology and infectious disease as well as a patient advocate. The Panel was convened for the purpose of creating this guideline. We followed previously validated procedures for creating evidence-based guidelines. Working groups focused on initial presentation, ongoing management, and empiric antifungal therapy. Each working group developed key clinical questions, conducted systematic reviews of the published literature, and compiled evidence summaries. The Grades of Recommendation Assessment, Development, and Evaluation approach was used to generate summaries, and evidence was classified as high, moderate, low, or very low based on methodologic considerations. Results Recommendations were made related to initial presentation (risk stratification, initial evaluation, and treatment), ongoing management (modification and cessation of empiric antibiotics), and empiric antifungal treatment (risk stratification, evaluation, and treatment) of pediatric FN. For each recommendation, the strength of the recommendation and level of evidence are presented. Conclusion This guideline represents an evidence-based approach to FN specific to children with cancer. Although some recommendations are similar to adult-based guidelines, there are key distinctions in multiple areas. Implementation will require adaptation to the local context. J Clin Oncol 30:4427-4438. (c) 2012 by American Society of Clinical Oncology

引用

页码：4427 / 4438

页数：12

共 147 条

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