Relevant bibliographies by topics / Febrile neutropenia Treatment

Academic literature on the topic 'Febrile neutropenia Treatment'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Febrile neutropenia Treatment"

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Martinez Lago, Nieves, Maria Vieito, Urbano Anido, Sonia Candamio, Rafael Lopez, Francisco J. Barón, Yolanda Vidal, et al. "Retrospective study of febrile neutropenia." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e19505-e19505. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e19505.

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e19505 Background: Although its mortality has decreased in the last years, neutropenic fever is still one of the most important oncological emergencies. Methods: We have assessed the epidemiological data on patients admitted or evaluated for neutropenic sepsis in a third level cancer center from January 2009 to December 2010. Results: We have found 68 patients who had at least one episode of febrile neutropenia, of them 66% were male and 34% female, and the mean age was 59 years. The performance status was 0 and 1 in 80% of patients and only 19% percent had serious comorbilities such as renal dysfunction, cirrhosis, diabetes mellitus or chronic pulmonary disease. 36% of our patients had a high risk neutropenic fever per MASCC criteria. The majority of patients were lung cancer (31%) breast cancer (22%); and gastrointestinal cancer (28%) and 53% where treated with palliative intention. The episodes of febrile neutropenia were more frequent in patients in first line of treatment (72%) and first cycle of any treatment (42%). 8% of patients were treated with chemorradiation and 35% of the patients were receiving prophylaxis with GCSF. There was no found the source of the infection in 45% of patients. 25% had positive cultures. The porcetaje of infections with gram-positive and-negative was very similar. Patients were treated with a combination of amikacine and ceftacidime in 63% of times, further addition of vancomicine or antifungical therapies were only needed in minority of patients, 88% percent of patients received granulocyte stimulating factors. The mean duration of the neutropenia was of 2 days. Following chemotherapy treatment doses were reduced in 44% of patients and delayed in 26%. Thirteen percent of patients received secondary prophylaxis with GCSF, treatment regimen changed was changed in only 2% of patients and 29% received no further treatment. Conclusions: The mortality rate was of 3%, and the time of hospitalization was short (mean of 7 days). Febrile neutropenia remains a serious complication that we have to decrease.
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Nucci, Marcio. "How I treat febrile neutropenia." Mediterranean Journal of Hematology and Infectious Diseases 13, no. 1 (February 26, 2021): e2021025. http://dx.doi.org/10.4084/mjhid.2021.025.

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The management of febrile neutropenia is a backbone of the treatment of patients with hematologic malignancies, and has evolved over the past decades. This article reviews my approach to the evaluation and treatment of febrile neutropenic patients. Key topics discussed include antibacterial and antifungal prophylaxis, the initial workup for fever, the choice of the empiric antibiotic regimen and its modifications, and criteria for discontinuation. For each of these questions, I review the literature and present my perspective.
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Rattanathammethee, Thanawat, Pokpong Piriyakhuntorn, Sasinee Hantrakool, Chatree Chai-Adisaksopha, Ekarat Rattarittamrong, Adisak Tantiworawit, Lalita Norasetthada, et al. "Gut Microbiota Profiles of Treatment-Naïve Adult Acute Myeloid Leukemia Patientswith Neutropenic Fever during Intensive Chemotherapy." Blood 136, Supplement 1 (November 5, 2020): 38–39. http://dx.doi.org/10.1182/blood-2020-140936.

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Background : The intestinal bacterial flora of febrile neutropenic patients has been found to be significantly diverse and may play a role in clinical decisions regarding antimicrobial de-escalation with predictive complications. However, there are few reports of microbiota alteration of adult acute myeloid leukemia (AML) patients. Methods : Stool samples of each treatment-naïve AML patient were collected the day before the initiation of induction chemotherapy (pretreatment), on the first date of neutropenic fever and first date of bone marrow recovery. Bacterial DNA was extracted from stool samples and bacterial 16s ribosomal RNA genes were sequenced by next-generation sequencing. Relative abundance, overall richness, Shannon's diversity index and Simpson's diversity index were calculated. Results : Ten AML patients (4 men and 6 women) were included with a median age of 39 years (range: 19-49). Twenty-four stool samples were collected and assigned into three groups: (1) pretreatment (n = 10); (2) first date of febrile neutropenia (n=9); and (3) first date of bone marrow recovery (n=5). All of patients developed febrile neutropenia; three patients had detectable infectious organisms and all of these cases had invasive pulmonary aspergillosis with two being co-infected with Pseudomonas pneumonia and Escherichia coli septicemia. Median absolute neutrophil count was 2.85 x 109/L (range: 1.42-7.67 x 109/L), 0.04 x 109/L (range: 0.01-0.43 x 109/L) and 3.65 x 109/L (range: 2.09-5.78 x 109/L) at pretreatment, first date of febrile neutropenia and first date of bone marrow recovery, respectively. At the phylum level, Firmicutes dominated over the period of neutropenic fever, subsequently declining after bone marrow recovery a pattern in contrast to that shown by Bacteroidetes and Proteobacteria. At the genus level, Enterococcus was more abundant in the febrile neutropenia period compared to pretreatment (mean difference of 20.2, [95%CI (5.9, 34.6)]; P <0.01) whileBacteroides and Escherichia notably declined during the same period (mean difference of -11.7, [95%CI (-21.9, -1.4)]; P= 0.027 and -11.6, [95%CI (-22.7, -0.4)]; P = 0.034, respectively). At the operational taxonomic units (OTUs) level, there was a significantly higher level of overall richness in the pretreatment period than in the febrile neutropenic episode (mean OTUs of 203.1 vs. 131.7; P = 0.012). Both of the diversity indexes of Shannon and Simpson showed a significant decrease in the febrile neutropenic period. Conclusions : Adult AML patients with a first episode of febrile neutropenia after initial intensive chemotherapy demonstrated a significant decrease in gut microbiota diversity and the level of diversity remained constant despite recovery of bone marrow. Figure Disclosures No relevant conflicts of interest to declare.
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4

Weissinger, F., and W. J. Heinz. "Prevention and treatment of febrile neutropenia." memo - Magazine of European Medical Oncology 5, no. 1 (April 2012): 30–34. http://dx.doi.org/10.1007/s12254-012-0335-2.

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5

Pichereau, Solen, Anne Le Louarn, Thierry Lecomte, Hélène Blasco, Chantal Le Guellec, and Hélène Bourgoin. "Cost-Effectiveness of UGT1A1*28 Genotyping in Preventing Severe Neutropenia Following FOLFIRI Therapy in Colorectal Cancer." Journal of Pharmacy & Pharmaceutical Sciences 13, no. 4 (January 3, 2011): 615. http://dx.doi.org/10.18433/j3wk5s.

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PURPOSE: Functional polymorphisms of the UGT1A1 gene, particularly the UGT1A1*28 variant, are associated with the severity of the bone marrow suppression in patients with metastatic colorectal cancer receiving irinotecan. This study assesses the cost-effectiveness of screening for UGT1A1*28 polymorphism associated with primary prophylactic Granulocytes Colony Stimulating Factor in patients homozygous for the *28 allele. The effectiveness was estimated based on the number of neutropenia avoided. METHODS: We modelled a theoretical population treated with combined 5-fluorouracil, leucovorin and irinotecan (FOLFIRI) for metastatic colorectal cancer. A decision tree simulated the health outcomes, measured by the prevalence of neutropenic events for two strategies, with or without UGT1A1 genotype screening. The model incorporated direct hospital costs and was validated with a sensitivity analysis. We calculated the cost-effectiveness ratio: CE=∆C / ∆E = "genotyping" cost – "no genotyping" cost / number of febrile neutropenia avoided. RESULTS: In the "genotyping strategy", the cost to avoid one febrile neutropenia event per 1000 patients treated was € 942.8 to € 1090.1. The sensitivity analysis showed a better CE ratio of € 733.4 to € 726.6 per febrile neutropenic event avoided.CONCLUSIONS: UGT1A1 genotype screening before irinotecan treatment is a cost-efficient strategy for the hospital. Systematic genotyping prior to chemotherapy, and administration of CSF in patients homozygotes for the *28 allele allow to avoid 91 febrile neutropenias at an acceptable cost.
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Nyatsanza, Ignatius, Irum Khan, Jennifer Windhorst, Nicole Gerardo, Kasandra Cadman, LeeAnn Valero, Eileen Knightly, Lawrence Eric Feldman, William Galanter, and Neeta K. Venepalli. "Timely antibiotic administration in febrile neutropenia." Journal of Clinical Oncology 35, no. 8_suppl (March 10, 2017): 204. http://dx.doi.org/10.1200/jco.2017.35.8_suppl.204.

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204 Background: The University of Illinois currently lacks a standard process to ensure timely antibiotic administration for patients with febrile neutropenia. The Infectious disease society of America (IDSA) guidelines recommend administration of antibiotics within two hours. Given the variability in patient encounters, we sought to implement an early identification and interventional strategy in the ambulatory setting for febrile neutropenic patients. A retrospective chart review over 10 weeks demonstrated that of 40 patients diagnosed with neutropenia 15 % (N = 6) had febrile neutropenia. Of these 6 patients, 50% (N = 3) received antibiotics within the IDSA time frame. We aimed to increase the percentage of febrile neutropenic patients receiving antibiotics within 2 hours from 50% to 100% in 8 weeks. Methods: A focus group at our quarterly morbidity mortality and improvement conference brainstormed a list of causes of delay in antibiotic initiation based on an index case discussion. A task force generated a pareto chart after affinity sorting the prior list, and created actual and ideal process maps, from identification of neutropenic patients to patient disposition. A standard operative protocol (SOP) was developed involving the creation and implementation of an electronic provider generated neutropenia check list triggering specific actions per IDSA recommendations, and a standardized order set including STAT cultures, and STAT antibiotics. Results: The febrile neutropenia SOP will be piloted over an 8 week period starting in early November in four ambulatory settings. The primary outcome data is the time from event to antibiotic administration. Process data will include time from event to antibiotic order, time from antibiotic order to administration and compliance with high risk neutropenic check list. We plan to assess our interventions every 3-4 weeks, and pilot at least 2 PDSA cycles within the next 8 weeks. Conclusions: Although febrile neutropenia is a recognized medical emergency with clear guidelines on treatment, not all patients may receive antibiotics within the appropriate time frame. It is therefore imperative for institutions to be aware of their level of IDSA compliance and implement appropriate quality improvements as required.
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Strojnik, Ksenija, Ksenija Mahkovic-Hergouth, Barbara Jezersek Novakovic, and Bostjan Seruga. "Outcome of severe infections in afebrile neutropenic cancer patients." Radiology and Oncology 50, no. 4 (December 1, 2016): 442–48. http://dx.doi.org/10.1515/raon-2016-0011.

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Abstract Background In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. Patients and methods We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test. Results We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17). Conclusions Afebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy.
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Naeem, Doaa, Majed Alshamrani, Mohammed Aseeri, and Mansoor Khan. "Prescribing Empiric Antibiotics for Febrile Neutropenia: Compliance with Institutional Febrile Neutropenia Guidelines." Pharmacy 6, no. 3 (August 10, 2018): 83. http://dx.doi.org/10.3390/pharmacy6030083.

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Background: Febrile neutropenia (FN) is an oncologic emergency which should be treated immediately with empiric antibiotics. Different institutions observe different antibiograms and use different FN management guidelines. Our center implemented FN management guidelines for adult cancer patients in 2009. Hence, we decided to assess compliance with FN management guidelines and to describe the pattern of bacterial infections. Method: We conducted a cross-sectional study on all adult cancer patients admitted with FN. Data were collected from electronic medical records between January and December 2014. Results: One hundred FN episodes met the study inclusion criteria. The mean age of the patients was 41 ± 17 years; 52% (52 patients) were women. The most common diagnosis was lymphoma (33%). In terms of compliance to institutional FN guidelines, 55% of patients received guideline non-compliant treatment. The most common non-compliant treatment was incorrect amikacin dosing in 31% of patients, followed by incorrect vancomycin dosing in 20%, incorrect piperacillin/tazobactam dosing in 19%, inappropriate use of carbapenems in 18%, and non-compliant vancomycin use in 12% of patients. Bacterial isolates were only observed in 19% of the FN episodes. Among these 19 episodes of FN, Gram-negative pathogens were predominant and were identified in 74% of the episodes, followed by Gram-positive pathogens in 16% and polymicrobial pathogens in 10%. The mean time to defervescence was 2.21 ± 2 days. Conclusion: Our study concluded that there was a high percentage of non-compliance with our institutional FN management guidelines. We recommend following appropriate empiric antibiotic doses and indications as per institutional guidelines.
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Lingaratnam, Senthil, Leon J. Worth, Monica A. Slavin, Craig A. Bennett, Suzanne W. Kirsa, John F. Seymour, Andrew Dalton, et al. "A cost analysis of febrile neutropenia management in Australia: ambulatory v. in-hospital treatment." Australian Health Review 35, no. 4 (2011): 491. http://dx.doi.org/10.1071/ah10951.

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Background. Adult febrile neutropenic oncology patients, at low risk of developing medical complications, may be effectively and safely managed in an ambulatory setting, provided they are appropriately selected and adequate supportive facilities and clinical services are available to monitor these patients and respond to any clinical deterioration. Methods. A cost analysis was modelled using decision tree analysis, published cost and effectiveness parameters for ambulatory care strategies and data from the State of Victoria’s hospital morbidity dataset. Two-way sensitivity analyses and Monte Carlo simulation were performed to evaluate the uncertainty of costs and outcomes associated with ambulatory care. Results. The modelled cost analysis showed that cost savings for two ambulatory care strategies were ~30% compared to standard hospital care. The weighted average cost saving per episode of ‘low-risk’ febrile neutropenia using Strategy 1 (outpatient follow-up only) was 35% (range: 7–55%) and that for Strategy 2 (early discharge and outpatient follow-up) was 30% (range: 7–39%). Strategy 2 was more cost-effective than Strategy 1 and was deemed the more clinically favoured approach. Conclusion. This study outlines a cost structure for a safe and comprehensive ambulatory care program comprised of an early discharge pathway with outpatient follow-up, and promotes this as a cost effective approach to managing ‘low-risk’ febrile neutropenic patients. What is known about the topic? Febrile neutropenia is a common complication of chemotherapy for patients with cancer. There is high level evidence supporting the use of ambulatory care strategies to manage patients with febrile neutropenia who are deemed to be at low risk of developing medical complications. What does this paper add? This paper highlights a cost structure for an adequately equipped and cost-effective ambulatory care strategy suitable for Australian hospitals to manage patients with low-risk febrile neutropenia. What are the implications for practitioners? The strategy advocated in this paper affords eligible patients the choice of early discharge from hospital. It advocates for improved resource utilisation and expansion of outpatient services in order to minimise opportunity costs faced by cancer treatment facilities.
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Morgan, Jessica E. "Fifteen minute consultation: Fever in children being treated for cancer." Archives of disease in childhood - Education & practice edition 104, no. 3 (August 13, 2018): 124–28. http://dx.doi.org/10.1136/archdischild-2017-314718.

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Fever is a common symptom in children receiving treatment for cancer. Clinicians and families are most concerned about febrile neutropenia, though non-neutropenic fever often causes more challenging treatment dilemmas. This article provides a structured approach to the initial assessment, examination, investigation and risk assessment of children with fever during treatment for childhood cancer. Non-neutropenic fever in children with cancer is not well researched. There are no systematic reviews of its management and no National Institute for Health and Care Excellence (NICE) (or other international) guidance about what to do. Features to consider when managing non-neutropenic fever are discussed. Febrile neutropenia, meanwhile, is an oncological emergency and requires management using standard sepsis principles including administration of broad-spectrum antibiotics. Relevant NICE guidance provides a clear structure for treatment. Ongoing management depends on the response to initial treatment.
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Dissertations / Theses on the topic "Febrile neutropenia Treatment"

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Bossaer, John B., and David Cluck. "Home Health Care of Patients With Febrile Neutropenia." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/2319.

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Febrile neutropenia is a potentially life-threatening oncologic emergency characterized by a dangerously low neutrophil count that places the patient at great risk. In these patients, fever may be the only sign of infection, which requires prompt treatment. With the increasing focus in shifting health care from inpatient centers to outpatient arenas, home health care clinicians will likely have an increased role in the care of neutropenic fever patients in the future. The article describes both the pharmacologic treatment and nonpharmacologic support required of these patients with particular attention to treatment that may be required in the patient?s home.
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Rosa, Regis Goulart. "Desfechos clínicos em neutropenia febril." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/119418.

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Neutropenia febril (NF) constitui complicação frequente do tratamento quimioterápico do câncer e está associada a altas taxas de morbimortalidade. O reconhecimento dos principais fatores associados ao desenvolvimento de desfechos clínicos desfavoráveis na NF é fundamental, uma vez que estes podem ser utilizados como marcadores prognósticos ou alvos terapêuticos. Este estudo objetiva determinar os principais fatores associados com mortalidade, tempo de hospitalização, incidência de bacteremia por patógenos multirresistentes e incidência de choque séptico no início da febre em pacientes hospitalizados com NF secundária à quimioterapia citotóxica para o câncer. Na presente coorte prospectiva composta por 305 episódios consecutivos de NF (em 169 pacientes com câncer) realizada em um hospital terciário no período de outubro de 2009 a agosto de 2011, as seguintes questões de pesquisa foram avaliadas: impacto do tempo de início da antibioticoterapia na mortalidade em 28 dias; fatores relacionados com tempo de hospitalização; impacto dos fatores microbiológicos da bacteremia no desenvolvimento de choque séptico no início do episódio de NF; fatores de risco para bacteremia por patógenos multirresistentes; impacto da bacteremia por Staphylococcus coagulase-negativo na mortalidade em 28 dias. Em 5 publicações distintas, os seguintes resultados foram notados: o atraso do início da antibioticoterapia está associado a maiores taxas de mortalidade em 28 dias; neoplasia hematológica, regimes quimioterápicos de altas doses, duração da neutropenia e bacteremia por Gram-negativos multirresistentes estão associados com períodos prolongados de internação por NF; infecção de corrente sanguínea polimicrobiana, bacteremia por Escherichia coli e bacteremia por Streptococcus viridans estão associados a choque séptico no início do episódio de NF; idade avançada, duração da neutropenia e presença de cateter venoso central estão associados com bacteremia por patógenos multirresistentes; bacteremia por Staphylococcus coagulase-negativo está associada a menores taxas de mortalidade em 28 dias quando comparado à bacteremia por outros patógenos.
Febrile neutropenia (FN) is a common complication of cancer chemotherapy and is associated with high morbidity and mortality rates. Recognition of the main factors associated with the development of adverse clinical outcomes in FN is crucial, given that these factors can be used as prognostic markers or therapeutic targets. This study aims to determine the main factors associated with mortality, length of hospital stay, incidence of bacteremia by multidrug-resistant pathogens and incidence of septic shock at the onset of fever in hospitalized patients with FN secondary to cancer cytotoxic chemotherapy. In the present prospective cohort of 305 FN episodes (in 169 cancer patients) conducted at a tertiary hospital from October 2009 to August 2011, the following research questions were evaluated: impact of time to antibiotic administration on 28-day mortality; factors associated with length of hospital stay; impact of microbiological factors of bacteremia on the development of septic shock at the onset of FN; risk factors for bacteremia by multidrug-resistant pathogens; impact of coagulasenegative Staphylococcus bacteremia on 28-day mortality. In 5 distinct publications, the following results were noted: delay of antibiotic administration is associated with higher 28-day mortality rates; hematologic malignancy, high-dose chemotherapy regimens, duration of neutropenia and bacteremia by multidrug-resistant Gram-negative bacteria are associated with prolonged length of hospital stay; polymicrobial bloodstream infection, bacteremia by Escherichia coli, and bacteremia by viridans sreptococci are associated with septic shock at the onset of FN; advanced age, duration of neutropenia and presence of indwelling central venous catheters are associated with bacteremia by multidrug-resistant pathogens; coagulase-negative Staphylococcus bacteremia is associated with lower 28-day mortality rates compared with bacteremia by other pathogens.
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Talbot, Marc Robert. "Why people in haematological and oncological care avoid or delay seeking medical treatment for infections caused by low white blood cell counts." Thesis, University of Exeter, 2012. http://hdl.handle.net/10036/3836.

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This article reports the findings of a grounded theory study of the processes involved in adherence and treatment seeking delay for febrile neutropenia in chemotherapy patients. Interviews were conducted with 12 patients. Six theoretical constructs were generated, namely ‘Recall of Treatment Advice’, ‘Impact of Emotions’, ‘Influence of Social Networks’, ‘Symptom Monitoring Behaviour’, ‘Symptom Interpretation’, and ‘Preparation and Journey Time’. A model was developed to reflect the complex interplay between these theoretical constructs. Data extracts are presented to illustrate the grounding of the model in patients’ accounts, and the model is discussed with reference to previous theory and research.
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Bossaer, John B. "Incidence and Treatment of Vancomycin-Resistant Enterococci (VRE) Infection in VRE Colonized Febrile Neutropenic Patients." Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/2338.

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Bossaer, John B. "Incidence and Treatment of Vancomycin-Resistant Enterococci (VRE) Infection in VRE Colonized Febrile Neutropenic Patients." Digital Commons @ East Tennessee State University, 2009. https://dc.etsu.edu/etsu-works/2362.

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Phillips, Robert Stephen. "Optimizing risk predictive strategies in febrile neutropenic episodes in children and young people undergoing treatment for malignant disease." Thesis, University of York, 2014. http://etheses.whiterose.ac.uk/6571/.

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The aim of this thesis was to investigate the clinical problem of the initial management of febrile neutropenia (FN) in children and young people undergoing treatment for malignant disease, to thoroughly evaluate the existing research, and to collect and synthesise this to quantify the risk of adverse clinical outcomes, through development of develop a new risk prediction model, using individual participant data (IPD). A further aim was to develop methodological approaches to IPD analysis in the development of predictive models, including the graphical display and communication of such information. The research produced five systematic reveiws of the existing medical literature in this area, and helped create a global collaboration of 19 research groups (PICNICC) which has shared data on over 5000 episodes of FN. This individual patient data was synthesised using hierarchical logistic regression meta-analysis to develop a new predictive model for MDI, which is robust to internal validation techniques (bootstrapping and leave-one-out cross-validation). The multivariable predictive model derived had six components: Tumour type, temperature, clinical description of being “severely unwell”, and the results of measurements of three elements of the full blood count: haemoglobin concentration, total white cell count and absolute monocyte count. It showed good overall fit (Brier[scaled] 4.5% discordancy), moderate discrimination (AU-ROC 0.736) and good calibration between predicted and actual estimates of the risk of MDI (calibration slope 0.95). We have demonstrated that such a data sharing project is feasible across many different jurisdictions and eras of study, and we now need to undertake a series of further projects to evaluate the model and go on to improve the management of paediatric FN across the world.
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Books on the topic "Febrile neutropenia Treatment"

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I, Rolston Kenneth V., and Rubenstein Edward B, eds. Textbook of febrile neutropenia. London: Martin Dunitz, 2001.

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Ison, Michael G. Upper Respiratory Symptoms During Febrile Neutropenia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199938568.003.0012.

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These case studies illustrate infections encountered in hospitals among patients with compromised immune systems. As a result of immunocompromise, the patients are vulnerable to common and uncommon infections. These cases are carefully chosen to reflect the most frequently encountered infections in the patient population, with an emphasis on illustrations and lucid presentations to explain state-of-the-art approaches in diagnosis and treatment. Common and uncommon presentations of infections are presented while the rare ones are not emphasized. The cases are written and edited by clinicians and experts in the field. Each of these cases highlights the immune dysfunction that uniquely predisposed the patient to the specific infection, and the cases deal with infections in the cancer patient, infections in the solid organ transplant recipient, infections in the stem cell recipient, infections in patients receiving immunosuppressive drugs, and infections in patients with immunocompromise that is caused by miscellaneous conditions.
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Champigneulle, Benoit, and Frédéric Pène. Pathophysiology and management of neutropenia in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0274.

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Neutropenia is defined by an absolute neutrophil count <500 per mm3. Chemotherapy-induced myelosuppression represents the main mechanism accounting for neutropenia, although various bone marrow disorders might also result in impaired granulopoiesis. Neutropenia, especially when profound and prolonged, is a major risk factor for severe bacterial and fungal infections. Early initiation of empirical broad-spectrum antibiotic therapy represents the cornerstone of the treatment of febrile neutropenia. A number of infected neutropenic patients may exhibit organ failures, such as acute respiratory failures and/or severe sepsis requiring intensive care unit (ICU) admission. This chapter discusses the particularities in the management of neutropenic patients in the ICU, including outcome and criteria for ICU admission, management of antimicrobials with respect to the current epidemiological trends, and other measures specific to this subgroup of patients.
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Howe, Christine K. An assessment of an antibiotic treatment algorithm for chemotherapy-induced febrile neutropenia: prescribing congruence and patient outcomes. 2003, 2003.

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Zhu, Nancy Y., and Cynthia Wu. Anaemia, cytopenias, and thrombosis in palliative medicine. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0083.

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Many haematological issues can complicate end-of-life care, including cytopenias and venous thromboembolism (VTE). Anaemia is very common and can significantly impact quality of life; causes include haemorrhage, iron deficiency, nutritional deficiencies, and bone marrow infiltration. Neutropenia from bone marrow failure as a result of disease infiltration or from chemotherapy effects can result in life-threatening infections. Finally, VTE is commonly seen in cancer patients as well as those who require prolonged hospitalization. Symptoms can cause discomfort, mortality is increased, and treatment is associated with major bleeding. Understanding the therapeutic options and their adverse side effects is essential in the management of these complex problems. Despite the presence of effective therapies, it is also important to realize that events such as febrile neutropenia and pulmonary embolism are often seen at the end of life and intervention may not always impact prognosis. The risks of intervention should be weighed against expected benefits when developing appropriate palliative care plans.
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Wilson, A. P. R., and Preet Panesar. Antimicrobial drugs in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0053.

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The pharmacokinetics of antimicrobials are altered in critically-ill patients, particularly in the presence of renal or hepatic failure. Maintaining a choice or diversity of antibiotics is important due to the emergence of resistance. Antibiotic use should also be kept to the minimum and local protocols need to be established. For community-acquired infection, co-amoxiclav or a parenteral cephalosporin can be used, while for hospital-acquired infection, piperacillin/tazobactam, ciprofloxacin, or ceftazidime are recommended. For suspected vascular catheter infection or methicillin-resistant Staphylococcus aureus (MRSA) infection, teicoplanin or vancomycin should be used, with meropenem or imipenem reserved for second line treatment. Prophylactic antibiotics should not be continued once a surgical patient has returned from the theatre. Patients with febrile neutropenia receive piptazobactam, meropenem, ceftazidime or ciprofloxacin and a glycopeptide. Antifungals, usually caspofungin or liposomal amphotericin, are used if fungal infection is suspected, especially after failed antibacterial treatment. Cephalosporin use has declined as they have been linked with emergence of MRSA and Clostridium difficile. However, this reflects overuse and they still have a place as part of a diverse choice of antibiotics. Vancomycin and teicoplanin use has increased greatly in order to treat MRSA and line infections, but resistance remains unusual. Carbapenem use has increased rapidly with the emergence of extended spectrum beta-lactamase producing Gram-negative bacteria.
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Book chapters on the topic "Febrile neutropenia Treatment"

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Carde, P. "Bone Marrow Protectors in Cancer Treatment." In Febrile Neutropenia, 7–9. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-642-60443-0_2.

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Klastersky, J. A. "Treatment of Neutropenic Infection: Trends Towards Monotherapy?" In Febrile Neutropenia, 47–52. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-642-60443-0_9.

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Mustafa, M. M. "Cefepime versus Ceftazidime in the Empiric Treatment of Febrile Neutropenic Children with Malignancy." In Febrile Neutropenia, 75–76. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-642-60443-0_14.

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Kibbler, C. C., and M. Aoun. "Liposomal Versus Conventional Amphotericin B for the Treatment of Fever of Unknown Origin in Neutropenic Patients: Results of Two Randomized Trials in 204 Children and 134 Adults." In Febrile Neutropenia, 101–2. Berlin, Heidelberg: Springer Berlin Heidelberg, 1997. http://dx.doi.org/10.1007/978-3-642-60443-0_20.

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Chao, Samantha, and Bora Lim. "Current Treatment of Febrile Neutropenia." In International Manual of Oncology Practice, 991–1006. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-16245-0_45.

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Rizvi, Syed M., and Bora Lim. "Current Treatment of Febrile Neutropenia: Tailored, Individual Based Therapy." In International Manual of Oncology Practice, 771–78. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-21683-6_36.

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Rivera, F., J. I. Mayordomo, M. T. Díaz-Puente, M. P. Lianes, M. López-Brea, E. López, L. Paz-Ares, S. Alonso, and H. Cortés-Funes. "Role of G-CSF and GM-CSF in the treatment of febrile neutropenia induced by chemotherapy ; preliminary results of a randomized trial." In Cancer Treatment An Update, 880–84. Paris: Springer Paris, 1994. http://dx.doi.org/10.1007/978-2-8178-0765-2_186.

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Zhu, Nancy, and Cynthia Wu. "Anaemia, cytopenias, and thrombosis in palliative medicine." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 937–46. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0088.

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Many haematological issues can complicate end of life care, including cytopenias and venous thromboembolism. Anaemia is very common and can significantly impact quality of life; causes include haemorrhage, iron deficiency, nutritional deficiencies, and bone marrow infiltration. Neutropenia from bone marrow failure as a result of disease infiltration or from chemotherapy effects can result in life-threatening infections. Finally, venous thromboembolism is commonly seen in cancer patients as well as those who require prolonged hospitalization. Symptoms can cause discomfort, mortality is increased, and treatment is associated with major bleeding. Understanding the therapeutic options and their adverse side effects is essential in the management of these complex problems. Despite the presence of effective therapies, it is also important to realize that events such as febrile neutropenia and pulmonary embolism are often seen at the end of life and intervention may not always impact prognosis. The risks of intervention should be weighed against expected benefits when developing appropriate palliative care plans.
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"Infection." In Paediatric Haemotology and Oncology, edited by Simon Bailey, Rod Skinner, Simon Bailey, and Rod Skinner, 235–62. Oxford University Press, 2022. http://dx.doi.org/10.1093/med/9780198779186.003.0017.

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Infection is very common in children with or undergoing treatment for malignancy who are at increased risk both of infections that occur commonly in healthy children and of opportunistic infections. Many underlying reasons and risk factors for this increased risk have been identified. Bacterial, fungal, viral and protozoal infections may all be serious or life-threatening. Prevention of infections is preferable to treating them and is an important aspect of management in children with malignancy. The assessment, investigation, diagnosis and management of febrile neutropenia and the system-specific infections most commonly encountered in children with cancer or leukaemia, including central venous access device-associated, respiratory, oro- and gastrointestinal, central nervous system, skin, soft tissue and urinary tract infections, are described.
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"Oncological emergencies and acute oncology." In Oxford Desk Reference: Oncology, edited by Thankamma Ajithkumar, Ann Barrett, Helen Hatcher, and Sarah Jefferies, 425–49. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198745440.003.0015.

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Recently the specialty of acute oncology with a clinical service to support patients and coordinate the care of those presenting with oncological emergencies has been developed. Patients who present with oncological emergencies often have a unique set of clinical problems, many of them iatrogenic, and can benefit from specialist advice from teams who are expert in the management of such conditions. Cancer treatments are developing and diversifying from standard cytotoxic chemotherapeutic drugs to targeted agents and immunological therapies. These introduce new toxicities such as dermatological problems, hypertension, and autoimmune phenomena. The management of the problem will vary depending on the underlying process and specific advice related to the causative agent will be required. This chapter covers oncological emergencies and acute oncology. Topics include tumour lysis syndrome; hypercalcaemia; hyponatraemia; hyperkalaemia; hypoglycaemia; hyperericaemia; febrile neutropenia; catheter associated infections; nausea, vomiting and diarrhoea; vascular complications; stridor and airway obstruction; superior vena cava obstruction; gastrointestinal obstruction; urinary tract obstruction; thrombocytopenia and disseminated intravascular coagulation; gastrointestinal bleeding; genitourinary bleeding; cardiorespiratory; cardiac tamponade; pleural effusion; brain metastases and raised intracranial pressure; spinal cord compression; impending and pathological fractures; and immune-related emergencies.
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Conference papers on the topic "Febrile neutropenia Treatment"

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Ben Abdallah, SS, N. Letarte, C. Messier, D. Charpentier, L. Yelle, R. Younan, and A. Bestawros. "Abstract P3-15-09: Impact of granulocyte colony-stimulating factors on febrile neutropenia risk during early-stage breast cancer treatment." In Abstracts: Thirty-Sixth Annual CTRC-AACR San Antonio Breast Cancer Symposium - Dec 10-14, 2013; San Antonio, TX. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/0008-5472.sabcs13-p3-15-09.

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Gascón, Pere, Matti Aapro, Heinz Ludwig, Mario Boccadoro, Carsten Bokemeyer, Matthew Turner, Michael Muenzberg, Ivo Abraham, Kris Denhaerynck, and Karen MacDonald. "Abstract P5-15-19: Prophylaxis of chemotherapy-induced febrile neutropenia with biosimilar filgrastim: Description of patients, treatment patterns and outcomes in the MONITOR-GCSF study in the breast cancer cohort." In Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium; December 9-13, 2014; San Antonio, TX. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.sabcs14-p5-15-19.

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Goel, Varun, Sajjan Singh, Vineet Talwar, Pankaj Goyal, and Amitabh Upadhyay. "Study of efficacy and safety of adjuvant intraperitoneal chemotherapy in carcinoma ovary." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685307.

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Background: The benefit of administering chemotherapy directly into the peritoneal cavity is supported by preclinical, clinical and pharmacokinetic data. In view of paucity of data from the Indian subcontinent, we decided to study the response and tolerability of intraperitoneal (I/P) chemotherapy in carcinoma ovary in Indian population. Methods: In this observational study, from March 2013 to June 2015, the efficacy and tolerability of adjuvant I/P chemotherapy in optimally cytoreduced stage III epithelial ovarian cancer patients were assessed. Treatment consisted of 135 mg/m2 of i.v. paclitaxel over a 3-hours period on day 1 followed by AUC 5 carboplatin i.v. on day 2 and 60 mg/m2 of i.p. paclitaxel on day 8 every 3 weekly for six cycles. Results: Total 50 patients were enrolled. The median age of patients was 53 yrs (32 yrs – 67 yrs). Out of a total of 240 I/P cycles, 225 cycles (93%) were completed. 30 patients (75%) received all the 6 cycles by IP route, 6 patients completed 5, 3 patients completed 4 cycles and 1 completed 3 I/P cycles. 4 Out of 30 patients who completed all 6 cycles of I/P chemotherapy, had one or more adjustment including delay while in 3 patients (7.5%) dose had to be reduced. after median follow up of 14 months, 8 patients (12.5%) had local or systemic recurrence, 2 patients (5%) had progression during treatment and died due to disease. median progression free survival not reached yet. One patients had vaginal leak. Catheter block was seen in five cases. Two cases had needle displacement and extravasations of drug around the port chamber. 6 patients had severe abdominal pain and cramp (grade 3) after infusion of saline. Hematologic toxicity was evaluated in all patients and in all cycles. Grade 3 or 4 Leucopenia was experienced by 25 patients (50%) but Febrile Neutropenia occurred in only 5 (10%) patients. Grade 3 or 4 anemia occurred in 17 (42.5%) and grade 3 or 4 thrombocytopenia was experienced by 6 patients (15%). Renal complication present in 3 patients (7.5%) and transient transfusion reaction developed in 5 patients. mucositis present in 21 patients. Conclusions: Adjuvant I/P chemotherapy in optimally cytoreduced epithelial ovarian cancer is active and well tolerated in Indian patients.
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