Premium
Current approaches for risk stratification of infectious complications in pediatric oncology
Author(s) -
Härtel Christoph,
Deuster Maresa,
Lehrnbecher Thomas,
Schultz Christian
Publication year - 2007
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21205
Subject(s) - medicine , febrile neutropenia , blood cancer , risk stratification , neutropenia , intensive care medicine , pediatric oncology , pediatric cancer , cancer , oncology , chemotherapy
Abstract Infections are serious complications of cytoreductive therapy in pediatric cancer patients presenting with febrile neutropenia. It is standard of care to initiate empirical intravenous broad‐spectrum antibiotics until the fever and neutropenia resolve. However, it might be effective and safe to allow for early hospital discharge in certain subgroups of patients. Two strategies for risk stratification of pediatric cancer patients with regard to infectious complications are discussed in this review: (1) clinical risk parameters and laboratory measures to assist therapeutic management at presentation with fever in neutropenia, and (2) investigations of individual genetic susceptibility factors to tailor potential prophylactic approaches. Given the data available from a significant number of small studies, a large prospective non‐inferiority trial is essential to assess low‐risk clinical factors and additional laboratory or genetic markers for their predictive value. Pediatr Blood Cancer 2007;49:767–773. © 2007 Wiley‐Liss, Inc.