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Fever and Neutropenia in Children With Cancer

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https://www.readbyqxmd.com/read/29652973/-febrile-neutropenia-in-cancer-patients-management-in-the-emergency-room
#1
Daniel Rivera-Salgado, Kathia Valverde-Muñoz, María L Ávila-Agüero
Febrile neutropenia is a life-threatening condition that requires immediate attention, especially in patients with chemotherapy-related neutropenia. Patients with febrile neutropenia have a much greater risk of developing bacterial disease, and fever may be the only indicator of severe bacterial infection. Adequate management of febrile neutropenia emphasizes early recognition of patients, risk stratification, and antibiotic therapy administration during the first 60 minutes of admission to an emergency room...
2018: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/29589346/-recommendations-for-diagnostics-and-therapy-of-children-with-cancer-presenting-with-fever-and-neutropenia-comparison-of-two-current-guidelines
#2
Thomas Lehrnbecher, Andreas Groll, Philipp Agyeman, Roland A Ammann, Andishe Attarbaschi, Uta Behrends, Christoph Berger, Axel Hamprecht, Markus Hufnagel, Hans-Jürgen Laws, Max Scheler, Christian Temme, Simon Vieth, Arne Simon
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...
March 27, 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29478800/granulocyte-transfusions-in-the-management-of-neutropenic-fever-a-pediatric-perspective
#3
REVIEW
Dilek Gurlek Gokcebay, Sibel Akpinar Tekgunduz
Severe neutropenia-associated invasive bacterial or fungal infections are still the major cause of mortality and morbidity in children receiving cancer chemotherapy. Granulocyte transfusion therapy has been used for many years in the management of neutropenic patients with severe infections in whom the clinical condition deteriorated despite appropriate antimicrobial treatment. Transfused granulocytes can increase the recipient's blood neutrophil count and accumulation of them into the site of infection. There are some data obtained from retrospective or prospective observational studies in pediatric granulocyte transfusion therapy, but results are not conclusive...
February 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/29462193/the-influence-of-different-fever-definitions-on-diagnostics-and-treatment-after-diagnosis-of-fever-in-chemotherapy-induced-neutropenia-in-children-with-cancer
#4
Stéphanie Wagner, Eva K Brack, Eveline Stutz-Grunder, Philipp Agyeman, Kurt Leibundgut, Oliver Teuffel, Roland A Ammann
BACKGROUND: There is no evidence-based definition of the temperature limit defining fever (TLDF) in children with neutropenia. Lowering the TLDF is known to increase the number of episodes of fever in neutropenia (FN). This study aimed to investigate the influence of a lower versus standard TLDF on diagnostics and therapy. METHODS: In a single pediatric cancer center using a high standard TLDF (39°C tympanic-temperature) patients were observed prospectively (NCT01683370)...
2018: PloS One
https://www.readbyqxmd.com/read/29200325/incidence-and-risk-factors-of-bacterial-and-fungal-infection-during-induction-chemotherapy-for-high-risk-neuroblastoma
#5
Sarah B Whittle, Kaitlin C Williamson, Heidi V Russell
High-risk neuroblastoma is an aggressive childhood cancer with poor outcomes. Treatment begins with an induction phase comprised of intense multi-agent chemotherapy with the goal of maximally reducing tumor bulk. Given the high intensity of induction chemotherapy, neutropenic fever and infectious complications are common; however, the actual incidence is difficult to determine from clinical trial reports. We performed a retrospective review of infection-related complications in 76 children treated for high-risk neuroblastoma at Texas Children's Hospital...
August 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29153062/-diagnostic-accuracy-of-the-lightcycler%C3%A2-septifast-assay-in-the-childhood-febrile-neutropenia
#6
Esra Mimaroğlu, Elvan Çağlar Çıtak, Necdet Kuyucu, Gönül Arslan
Infection is the main problem among the patients receiving cancer therapy. The mortality rate can be reduced by the appropriate treatment in the right time. Although blood culture is the gold standard for the diagnoses of sepsis, many factors influence the results of blood culture in children. For this reason, real time polymerase chain reaction (Rt-PCR) has gained importance for the diagnoses of microbiological agents as it is faster than the conventional methods. In this study, we aimed to compare the efficacy of SeptiFast (SF) test with blood culture among children with neutropenic fever...
October 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28877157/external-validation-of-six-pediatric-fever-and-neutropenia-clinical-decision-rules
#7
Gabrielle M Haeusler, Karin A Thursky, Monica A Slavin, Francoise Mechinaud, Franz E Babl, Penelope Bryant, Richard De Abreu Lourenco, Robert Phillips
BACKGROUND: Fever and neutropenia (FN) clinical decision rules (CDRs) are recommended to help distinguish children with cancer at high and low risk of severe infection. The aim of this study was to validate existing pediatric FN CDRs designed to stratify children with cancer at high or low risk of serious infection or medical complication. METHODS: Pediatric CDRs suitable for validation were identified from a literature search. Relevant data were extracted from an existing data set of 650 retrospective FN episodes in children with cancer...
April 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28696047/a-randomized-trial-of-the-effectiveness-of-the-neutropenic-diet-versus-food-safety-guidelines-on-infection-rate-in-pediatric-oncology-patients
#8
RANDOMIZED CONTROLLED TRIAL
Karen M Moody, Rebecca A Baker, Ruth O Santizo, Inan Olmez, Jeanie M Spies, Amanda Buthmann, Linda Granowetter, Robin Y Dulman, Kanyalakshmi Ayyanar, Jonathan B Gill, Aaron E Carroll
BACKGROUND: The neutropenic diet (ND) is prescribed to avoid introduction of bacteria into a host's gastrointestinal tract and reduce infection. Due to a lack of evidence to support the ND, there continues to be debate among pediatric oncologists regarding its usefulness. This prospective randomized controlled trial evaluated the difference in neutropenic infection rates in pediatric oncology patients randomized to Food and Drug Administration approved food safety guidelines (FSGs) versus the ND plus FSGs during one cycle of chemotherapy...
January 2018: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28691431/low-dose-computed-tomography-in-assessment-of-pulmonary-abnormalities-in-children-with-febrile-neutropenia-suffering-from-malignant-diseases
#9
Urszula Zaleska-Dorobisz, Cyprian Olchowy, Mateusz Łasecki, Dąbrówka Sokołowska-Dąbek, Aleksander Pawluś, Jowita Frączkiewicz, Ewa Gorczyńska
BACKGROUND: Management of febrile neutropenia in pediatric patients is challenging. Chest X-ray and CT scan help to identify infective foci; however, exposure to radiation is a risk factor for development of secondary cancer. For this reason, attention is paid to reducing radiation exposure. OBJECTIVES: The aim of the study was to define the role of LDCT examination in the early detection of pulmonary lesions in children during oncology or autoimmune treatment complicated by neutropenia-related fever...
July 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28609435/predicting-infectious-complications-in-children-with-cancer-an-external-validation-study
#10
Gabrielle M Haeusler, Karin A Thursky, Francoise Mechinaud, Franz E Babl, Richard De Abreu Lourenco, Monica A Slavin, Robert Phillips
BACKGROUND: The aim of this study was to validate the 'Predicting Infectious ComplicatioNs in Children with Cancer' (PICNICC) clinical decision rule (CDR) that predicts microbiologically documented infection (MDI) in children with cancer and fever and neutropenia (FN). We also investigated costs associated with current FN management strategies in Australia. METHODS: Demographic, episode, outcome and cost data were retrospectively collected on 650 episodes of FN...
July 11, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28549783/irinotecan-temozolomide-with-temsirolimus-or-dinutuximab-in-children-with-refractory-or-relapsed-neuroblastoma-cog-anbl1221-an-open-label-randomised-phase-2-trial
#11
RANDOMIZED CONTROLLED TRIAL
Rajen Mody, Arlene Naranjo, Collin Van Ryn, Alice L Yu, Wendy B London, Barry L Shulkin, Marguerite T Parisi, Sabah-E-Noor Servaes, Mitchell B Diccianni, Paul M Sondel, Julia G Bender, John M Maris, Julie R Park, Rochelle Bagatell
BACKGROUND: Outcomes for children with relapsed and refractory neuroblastoma are dismal. The combination of irinotecan and temozolomide has activity in these patients, and its acceptable toxicity profile makes it an excellent backbone for study of new agents. We aimed to test the addition of temsirolimus or dinutuximab to irinotecan-temozolomide in patients with relapsed or refractory neuroblastoma. METHODS: For this open-label, randomised, phase 2 selection design trial of the Children's Oncology Group (COG; ANBL1221), patients had to have histological verification of neuroblastoma or ganglioneuroblastoma at diagnosis or have tumour cells in bone marrow with increased urinary catecholamine concentrations at diagnosis...
July 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28459614/guideline-for-the-management-of-fever-and-neutropenia-in-children-with-cancer-and-hematopoietic-stem-cell-transplantation-recipients-2017-update
#12
REVIEW
Thomas Lehrnbecher, Paula Robinson, Brian Fisher, Sarah Alexander, Roland A Ammann, Melissa Beauchemin, Fabianne Carlesse, Andreas H Groll, Gabrielle M Haeusler, Maria Santolaya, William J Steinbach, Elio Castagnola, Bonnie L Davis, L Lee Dupuis, Aditya H Gaur, Wim J E Tissing, Theo Zaoutis, Robert Phillips, Lillian Sung
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...
June 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28437150/cost-of-cancer-related-neutropenia-or-fever-hospitalizations-united-states-2012
#13
Eric Tai, Gery P Guy, Angela Dunbar, Lisa C Richardson
PURPOSE: Neutropenia and subsequent infections are life-threatening treatment-related toxicities of chemotherapy. Among patients with cancer, hospitalizations related to neutropenic complications result in substantial medical costs, morbidity, and mortality. Previous estimates for the cost of cancer-related neutropenia hospitalizations are based on older and limited data. This study provides nationally representative estimates of the cost of cancer-related neutropenia hospitalizations...
June 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27856269/efficacy-and-safety-of-withholding-antimicrobial-treatment-in-children-with-cancer-fever-and-neutropenia-with-a-demonstrated-viral-respiratory-infection-a-randomized-clinical-trial
#14
RANDOMIZED CONTROLLED TRIAL
M E Santolaya, A M Alvarez, M Acuña, C L Avilés, C Salgado, J Tordecilla, M Varas, M Venegas, M Villarroel, M Zubieta, A Toso, A Bataszew, M J Farfán, V de la Maza, A Vergara, R Valenzuela, J P Torres
OBJECTIVES: To determine efficacy and safety of withholding antimicrobials in children with cancer, fever and neutropenia (FN) with a demonstrated respiratory viral infection. METHODS: Prospective, multicentre, randomized study in children presenting with FN at five hospitals in Santiago, Chile, evaluated at admission for diagnosis of bacterial and viral pathogens including PCR-microarray for 17 respiratory viruses. Children positive for a respiratory virus, negative for a bacterial pathogen and with a favourable evolution after 48 h of antimicrobial therapy were randomized to either maintain or withhold antimicrobials...
March 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27518750/respiratory-viral-infections-and-coinfections-in-children-with-cancer-fever-and-neutropenia-clinical-outcome-of-infections-caused-by-different-respiratory-viruses
#15
MULTICENTER STUDY
Juan Pablo Torres, Verónica De la Maza, Lisette Kors, Milena Villarroel, Paula Piemonte, Giannina Izquierdo, Carmen Salgado, Juan Tordecilla, Verónica Contardo, Mauricio J Farfán, Asunción Mejías, Octavio Ramilo, María Elena Santolaya
BACKGROUND: Respiratory viral infections in episodes of fever and neutropenia (FN) in children with cancer are not well characterized. We compared the clinical outcome of infections caused by different respiratory viruses (RVs) and by RV coinfection in this population. METHODS: Children with cancer and FN at 3 hospitals in Chile were prospectively evaluated by clinical examination, blood cultures and detection of 17 RVs using multiplex polymerase chain reaction (nasopharyngeal samples)...
September 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27400951/adrenomedullin-predicts-high-risk-and-culture-positivity-in-children-with-solid-tumors-suffering-from-neutropenic-fever
#16
Vural Kesik, Erman Ataş, Yasemin Gülcan Kurt, Fevzi Nuri Aydın, Oğuzhan Babacan, Mustafa Gülgün, Nadir Korkmazer
AIM OF STUDY: Neutropenic fever is a source of morbidity and mortality in children with cancer. It is not possible to detect the causative agent in cultures in most cases; the research for a marker that can show the severity of the disease is ongoing. We evaluated the role of adrenomedullin (ADM) at predicting prognosis on patients with febrile neutropenia, which has been proven to be a good prognostic marker for diseases with high morbidity and mortality, such as heart failure, ischemic ventricular dysfunction, sepsis, and systemic inflammatory response syndrome...
September 2016: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/27258771/simultaneous-bilateral-ophthalmic-artery-chemosurgery-for-bilateral-retinoblastoma-tandem-therapy
#17
David H Abramson, Brian P Marr, Jasmine H Francis, Ira J Dunkel, Armida W M Fabius, Scott E Brodie, Ijah Mondesire-Crump, Y Pierre Gobin
OBJECTIVE: Report on the 7-year experience with bilateral ophthalmic artery chemosurgery (OAC-Tandem therapy) for bilateral retinoblastoma. DESIGN: Retrospective, single institution study. SUBJECTS: 120 eyes of 60 children with bilateral retinoblastoma treated since March 2008. METHODS: Retrospective review of all children treated at Memorial Sloan Kettering with bilateral ophthalmic artery chemosurgery (Melphalan, Carboplatin, Topotecan, Methotrexate) delivered in the same initial session to both naïve and previously treated eyes...
2016: PloS One
https://www.readbyqxmd.com/read/27107610/low-bacterial-diet-versus-control-diet-to-prevent-infection-in-cancer-patients-treated-with-chemotherapy-causing-episodes-of-neutropenia
#18
REVIEW
Elvira C van Dalen, Arno Mank, Edith Leclercq, Renée L Mulder, Michelle Davies, Marie José Kersten, Marianne D van de Wetering
BACKGROUND: Neutropenia is a potentially serious side effect of chemotherapy and a major risk factor for infection, which can be life-threatening. It has been hypothesised that a low bacterial diet (LBD) can prevent infection and (infection-related) mortality in cancer patients receiving chemotherapy that causes episodes of neutropenia, but much remains unclear. This review is an update of a previously published Cochrane review. OBJECTIVES: The primary objective of this review was to determine the efficacy of an LBD versus a control diet in preventing infection and in decreasing (infection-related) mortality in adult and paediatric cancer patients receiving chemotherapy that causes episodes of neutropenia...
April 24, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27103976/serum-endocan-levels-in-children-with-febrile-neutropenia
#19
Eylem Kiral, Ener Cagri Dinleyici, Ayse Bozkurt-Turhan, Ozcan Bor, Yurdanur Akgun, Necat Akdeniz Akgun
Endocan is an endotelial cell specific molecule; previous studies have shown that serum endocan levels increased in cancer and sepsis and are also related to the severity of sepsis. There are no clinical study about serum endocan levels in children with febrile neutropenia. The aim of this study was to evaluate serum endocan levels in pediatric leukemia patients with febrile neutropenia (n=33) and compare them with children with leukemia without fever (n=33) and also with healthy children (n=24). The median serum endocan level in the first group (children with febrile neutropenia) was statistically significantly higher compared to the leukemic children without febrile neutropenia and also control group (P<0...
March 17, 2016: Hematology Reports
https://www.readbyqxmd.com/read/26954719/predicting-microbiologically-defined-infection-in-febrile-neutropenic-episodes-in-children-global-individual-participant-data-multivariable-meta-analysis
#20
Robert S Phillips, Lillian Sung, Roland A Ammann, Richard D Riley, Elio Castagnola, Gabrielle M Haeusler, Robert Klaassen, Wim J E Tissing, Thomas Lehrnbecher, Julia Chisholm, Hana Hakim, Neil Ranasinghe, Marianne Paesmans, Ian M Hann, Lesley A Stewart
BACKGROUND: Risk-stratified management of fever with neutropenia (FN), allows intensive management of high-risk cases and early discharge of low-risk cases. No single, internationally validated, prediction model of the risk of adverse outcomes exists for children and young people. An individual patient data (IPD) meta-analysis was undertaken to devise one. METHODS: The 'Predicting Infectious Complications in Children with Cancer' (PICNICC) collaboration was formed by parent representatives, international clinical and methodological experts...
March 15, 2016: British Journal of Cancer
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