Abstract
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.
| Original language | English |
|---|---|
| Pages (from-to) | 4427-4438 |
| Number of pages | 12 |
| Journal | Journal of Clinical Oncology |
| Volume | 30 |
| Issue number | 35 |
| DOIs | |
| Publication status | Published - Dec 10 2012 |
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ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation. / Lehrnbecher, Thomas; Phillips, Robert; Alexander, Sarah; Alvaro, Frank; Carlesse, Fabianne; Fisher, Brian; Hakim, Hana; Santolaya, Maria; Castagnola, Elio; Davis, Bonnie L.; Lee Dupuis, L.; Gibson, Faith; Groll, Andreas H.; Gaur, Aditya; Gupta, Ajay; Kebudi, Rejin; Petrilli, Sérgio; Steinbach, William J.; Villarroel, Milena; Zaoutis, Theoklis; Sung, Lillian.
In: Journal of Clinical Oncology, Vol. 30, No. 35, 10.12.2012, p. 4427-4438.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation
AU - Lehrnbecher, Thomas
AU - Phillips, Robert
AU - Alexander, Sarah
AU - Alvaro, Frank
AU - Carlesse, Fabianne
AU - Fisher, Brian
AU - Hakim, Hana
AU - Santolaya, Maria
AU - Castagnola, Elio
AU - Davis, Bonnie L.
AU - Lee Dupuis, L.
AU - Gibson, Faith
AU - Groll, Andreas H.
AU - Gaur, Aditya
AU - Gupta, Ajay
AU - Kebudi, Rejin
AU - Petrilli, Sérgio
AU - Steinbach, William J.
AU - Villarroel, Milena
AU - Zaoutis, Theoklis
AU - Sung, Lillian
PY - 2012/12/10
Y1 - 2012/12/10
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84870755899&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870755899&partnerID=8YFLogxK
U2 - 10.1200/JCO.2012.42.7161
DO - 10.1200/JCO.2012.42.7161
M3 - Article
C2 - 22987086
AN - SCOPUS:84870755899
VL - 30
SP - 4427
EP - 4438
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 35
ER -