Abstract
Febrile neutropenia (FN) is a common complication of chemotherapy in oncological children and one of the most important causes of morbidity and mortality in these patients. The early detection of a bacteremia and the rapid therapeutic intervention are crucial to improve the outcome. We analyzed the literature in order to clarify the epidemiology of FN in children undergoing chemotherapy, the specific factors associated with a negative outcome, the most common etiology, and the value of biological markers as a tool to make an early diagnosis or to monitor the evolution of the infection. Several studies have tried to identify specific factors that could help the clinician in the detection of an infection and in its microbiological identification. However, due to the heterogenicity of the available studies, sufficient evidence is lacking to establish the role of these risk factors in clinical practice and future research on this topic appear mandatory. Determinations of risk factors, etiology, and markers of febrile episodes in these patients are complicated by the characteristics of the underlying illness and the effects of treatments received. Although some studies have tried to develop an evidence-based guideline for the empiric management of FN in pediatrics, validated predictive scores and algorithms are still lacking and urgently needed.
Highlights
Over the last decades, the prognosis of pediatric malignancies has progressively changed due to many factors, including a better knowledge of the biology of the diseases and an impressive improvement in supportive care
Several researchers have tried to identify specific factors that could help the clinician in the detection of an infection and in its microbiological identification to improve the outcome of these children [2]
We analyzed the literature in order to clarify the epidemiology of febrile neutropenia (FN) in oncological children undergoing chemotherapy, the specific factors associated with a negative outcome in these patients, the most common etiology, and the value of biological markers as a tool to make an early diagnosis or to monitor the evolution of the infection
Summary
The prognosis of pediatric malignancies has progressively changed due to many factors, including a better knowledge of the biology of the diseases and an impressive improvement in supportive care. Remains a common complication of chemotherapy in oncological patients and one of the most important causes of morbidity and mortality [1,2]. Several researchers have tried to identify specific factors that could help the clinician in the detection of an infection and in its microbiological identification to improve the outcome of these children [2]. We analyzed the literature in order to clarify the epidemiology of FN in oncological children undergoing chemotherapy, the specific factors associated with a negative outcome in these patients, the most common etiology, and the value of biological markers as a tool to make an early diagnosis or to monitor the evolution of the infection
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