The authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. This study was conducted as a routine quality initiative at the Dana-Farber Cancer Institute/Brigham and Women’s Hospital. No grant support was used for this study or manuscript production. A portion of this work was presented at the American Society for Blood and Marrow Transplantation Tandem Meeting in February 2013.
The authors would like to thank all of the DFCI Bone Marrow Transplant Physician Assistants who helped make this quality initiative possible by actively managing the orders of their peers and physician moonlighters.
FreifeldAGBowEJSepkowitzKA. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis2011;52:e56–93.
CoxJADeMasiJMcCollomS. The diagnostic utility of routine chest radiography in the evaluation of the initial fever in patients undergoing hematopoietic stem cell. Pediatr Blood Cancer2011;57:666–668.
RenoultEButeauCTurgeonN. Is routine chest radiography necessary for the initial evaluation of fever in neutropenic children with cancer?Pediatr Blood Cancer2004;43:224–228.
RobertsSDWellsGMGandhiNM. Diagnostic value of routine chest radiography in febrile, neutropenic children for early detection of pneumonia and mould infections. Supportive Care Cancer2012;20:2589–2594.
FeusnerJCohenRO’LearyMBeachB. Use of routine chest radiography in the evaluation of fever in neutropenic pediatric oncology patients. J Clin Oncol1988;6:1699–1702.
LehrnbecherTPhillipsRAlexanderS. Guideline for the management of fever and neutropenia in children with cancer and/or undergoing hematopoietic stem-cell transplantation. J Clin Oncol2012;30:4427–4438.
BadenLRBensingerWAngaroneM. NCCN Clinical Practice Guidelines in Oncology: Prevention and Treatment of Cancer-Related Infections. Version 22014. Available at: NCCN.org. Accessed January 1 2014.
KatzJABashRRollinsN. The yield of routine chest radiography in children with cancer hospitalized for fever and neutropenia. Cancer1991;68:940–943.
KoronesDNHussongMRGullaceMA. Routine chest radiography of children with cancer hospitalized for fever and neutropenia: is it really necessary?Cancer1997;80:1160–1164.
BarloonTJGalvinJRMoriM. High-resolution ultrafast chest CT in the clinical management of febrile bone marrow transplant patients with normal or nonspecific chest roentgenograms. Chest1991;99:928–933.
Oude NijhuisCSGietemaJAVellengaE. Routine radiography does not have a role in the diagnostic evaluation of ambulatory adult febrile neutropenic cancer patients. Eur J Cancer2003;39:2495–2498.
NaviganteAHCerchiettiLCCostantiniP. Conventional chest radiography in the initial assessment of adult cancer patients with fever and neutropenia. Cancer Control2002;9:346–351.
RoyVAliLISelbyGB. Routine chest radiography for the evaluation of febrile neutropenic patients after autologous stem cell transplantation. Am J Hematol2000;64:170–174.
LeeSJZahriehDAlyeaEP. Comparison of T-cell-depleted and non-T-cell-depleted unrelated donor transplantation for hematologic diseases: clinical outcomes, quality of life, and costs. Blood2002;100:2697–2702.
Smith-BindmanRMigliorettiDLJohnsonE. Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996-2010. JAMA2012;307:2400–2409.