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Febrile neutropenia, anticancer chemotherapy

Febrile neutropenia, anticancer chemotherapy

Febrile neutropenia, anticancer chemotherapy

High risk, initial empiric treatment
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High-risk group includes:

  • inpatients status at time of development of fever
  • significant medical comorbidity or clinically unstable
  • anticipated, prolonged and severe neutropenia (≤100 cells/μL and ≥7 days)
  • hepatic insufficiency (5 times ULN for aminotransferase)
  • renal insufficiency (creatinine clearance <30 mL/min)
  • uncontrolled/progressive cancer
  • pneumonia or other complex infections at clinical presentation
  • alemtuzumab
  • mucositis grade 3-4
  • MASCC risk index <21

High risk with persistent fever during 3-5 days
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High-risk group includes:

  • inpatients status at time of development of fever
  • significant medical comorbidity or clinically unstable
  • anticipated, prolonged and severe neutropenia (≤100 cells/μL and ≥7 days)
  • hepatic insufficiency (5 times ULN for aminotransferase)
  • renal insufficiency (creatinine clearance <30 mL/min)
  • uncontrolled/progressive cancer
  • pneumonia or other complex infections at clinical presentation
  • alemtuzumab
  • mucositis grade 3-4
  • MASCC risk index <21

Low risk
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Low-risk group includes:

  • outpatients status at time of development of fever
  • no associated acute comorbid illness
  • independently indicating inpatient treatment or close observation
  • good performance status (ECOG 0-1)
  • no hepatic or renal insufficiency
  • MASCC risk index ≥21