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Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem cell transplantation

Lehrnbecher, T, Phillips, R, Alexander, S, Alvaro, F, Carlesse, F, Fisher, B, Hakim, H, Satolaya, M, Castagnola, E, Davies, B, Dupuis, LL, Gibson, F, Groll, AH, Gaur, A, Gupta, A, Kebudi, R, Petrilli, S, Steinback, WJ, Villarroel, M, Zaoutis, T and Sung, L (2012) Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem cell transplantation Journal of Clinical Oncology, 30 (35). pp. 4427-4438.

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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.

Item Type: Article
Subjects : Biosciences and Medicine
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
AuthorsEmailORCID
Lehrnbecher, TUNSPECIFIEDUNSPECIFIED
Phillips, RUNSPECIFIEDUNSPECIFIED
Alexander, SUNSPECIFIEDUNSPECIFIED
Alvaro, FUNSPECIFIEDUNSPECIFIED
Carlesse, FUNSPECIFIEDUNSPECIFIED
Fisher, BUNSPECIFIEDUNSPECIFIED
Hakim, HUNSPECIFIEDUNSPECIFIED
Satolaya, MUNSPECIFIEDUNSPECIFIED
Castagnola, EUNSPECIFIEDUNSPECIFIED
Davies, BUNSPECIFIEDUNSPECIFIED
Dupuis, LLUNSPECIFIEDUNSPECIFIED
Gibson, FUNSPECIFIEDUNSPECIFIED
Groll, AHUNSPECIFIEDUNSPECIFIED
Gaur, AUNSPECIFIEDUNSPECIFIED
Gupta, AUNSPECIFIEDUNSPECIFIED
Kebudi, RUNSPECIFIEDUNSPECIFIED
Petrilli, SUNSPECIFIEDUNSPECIFIED
Steinback, WJUNSPECIFIEDUNSPECIFIED
Villarroel, MUNSPECIFIEDUNSPECIFIED
Zaoutis, TUNSPECIFIEDUNSPECIFIED
Sung, LUNSPECIFIEDUNSPECIFIED
Date : 17 September 2012
Identification Number : 10.1200/JCO.2012.42.7161
Copyright Disclaimer : © 2012 by American Society of Clinical Oncology
Depositing User : Symplectic Elements
Date Deposited : 01 Jun 2016 16:42
Last Modified : 01 Jun 2016 16:50
URI: http://epubs.surrey.ac.uk/id/eprint/810895

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