Immunocompromised children and adolescents receiving treatment for cancer have a considerably increased risk for infection. Neutropenia is the most important single risk factor for infectious complications, and fever in neutropenia is considered as an emergency. Whereas guidelines for the management of fever in neutropenic adults have been established for decades, specific pediatric guidelines have not been developed until recently. As children differ in many aspects from adults such as in the underlying malignancy or in the availability and dosing of antimicrobial compounds, guidelines for pediatric patients are important. This article reviews similarities and differences between the recently published German interdisciplinary guideline of the German Societies of Pediatric Infectious Diseases and Pediatric Oncology and Hematology and a guideline developed by a panel of international experts for the management of fever in neutropenia in children and adolescents.
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http://dx.doi.org/10.1055/s-0044-101953 | DOI Listing |
Antibiotics (Basel)
December 2024
Infectious Diseases Research Program, Center for Bone Marrow Transplantation and Department of Pediatric Hematology/Oncology, University Children's Hospital, 48149 Muenster, Germany.
: Empirical antibacterial therapy for febrile neutropenia reduces mortality due to Gram-negative blood stream infections (BSIs). Pediatric guidelines recommend monotherapy with an antipseudomonal beta-lactam or a carbapenem and to add a second anti-Gram-negative agent in selected situations. We evaluated the changes in the proportions of resistance of beta-lactam monotherapies vs.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Department of Hematology, Hospital Clínic Barcelona, 08036 Barcelona, Spain.
Even though venetoclax in combination with azacitidine (VenAza) is considered a low-intensity regimen, its patients present a high incidence of cytopenia and infections during the first courses, making the initial management a challenging phase. This difficulty in our center led to the establishment of an At-Home (AH) program for ramp-up and follow-up patients during the VenAza combination induction phase focused on therapy administration, patient and caregiver education, and management of adverse events (AEs). A total of 70 patients with newly diagnosed acute myeloid leukemia (ND-AML) or relapsed/refractory AML (R/R AML) were treated with VenAza from March 2019 to May 2022.
View Article and Find Full Text PDFAndes Pediatr
October 2024
Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Unlabelled: Cancer remains one of the most important diseases in public health.
Objective: To estimate 5-year survival in pediatric cancer patients affected by FN, according to clinical-demographic variables.
Patients And Method: Survival, prognostic, and analytical study with historical cohort.
Cureus
December 2024
Public Health and Preventive Medicine, State University of New York Upstate Medical University, Syracuse, USA.
Background The management of neutropenic fever patients remains challenging. Patients' individual baseline body temperature may provide diagnostic and prognostic value. Methods This study is a retrospective analysis of 92 adults admitted for neutropenic fever to model the length of stay (LOS) and the ability to find a definitive diagnosis using the deviation of patients' temperature on admission from their outpatient baseline, acuity on admission, neutropenia level and persistence, fever persistence, and patients' age.
View Article and Find Full Text PDFIntroduction: Dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) therapy is indicated as first-line or neoadjuvant chemotherapy (NAC) for patients with advanced or metastatic urothelial carcinoma (UC). However, no studies reported ddMVAC therapy with pegfilgrastim (3.6 mg) in Japanese patients.
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