Prevention and Treatment of Cancer-Related Infections, Version 3.2024, NCCN Clinical Practice Guidelines in Oncology

Authors:
Lindsey Robert Baden Dana-Farber Cancer Institute

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Sankar Swaminathan Huntsman Cancer Institute at the University of Utah

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Nikolaos G. Almyroudis Roswell Park Comprehensive Cancer Center

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Michael Angarone Robert H. Lurie Comprehensive Cancer Center of Northwestern University

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Aliyah Baluch Moffitt Cancer Center

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Nicolas Barros Indiana University Melvin and Bren Simon Comprehensive Cancer Center

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Brian Buss University of Wisconsin Carbone Cancer Center

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Stuart Cohen UC Davis Comprehensive Cancer Center

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Brenda Cooper Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute

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Augusto Dulanto Chiang Vanderbilt-Ingram Cancer Center

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Zeinab El Boghdadly The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute

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Kevin Gregg University of Michigan Rogel Cancer Center

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Hana Hakim St. Jude Children’s Research Hospital

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Dora Ho Stanford Cancer Institute

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Fareed Khawaja The University of Texas MD Anderson Cancer Center

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Rachael Lee O’Neal Comprehensive Cancer Center at UAB

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Francesca Lee UT Southwestern Simmons Comprehensive Cancer Center

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Cathy Logan UC San Diego Moores Cancer Center

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Kristen Manley Fox Chase Cancer Center

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Ashrit Multani UCLA Jonsson Comprehensive Cancer Center

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Anupam Pande Washington University School of Medicine

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Steven Pergam Fred Hutchinson Cancer Center

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Jennifer Pisano The UChicago Medicine Comprehensive Cancer Center

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Jennifer Saullo Duke Cancer Institute

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Mindy Schuster Abramson Cancer Center at the University of Pennsylvania

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Susan K. Seo Memorial Sloan Kettering Cancer Center

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Shmuel Shoham Johns Hopkins Kimmel Cancer Center

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Randy Taplitz City of Hope National Medical Center

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Jeffrey Topal Yale Cancer Center/Smilow Cancer Hospital

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John W. Wilson Mayo Clinic Comprehensive Cancer Center

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Andrea Zimmer Fred & Pamela Buffet Cancer Center

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Carly J. Cassara National Comprehensive Cancer Network

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Rashmi Kumar National Comprehensive Cancer Network

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Zeenat Diwan National Comprehensive Cancer Network

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Volume/Issue:
Volume 22: Issue 9
Online Publication Date:
Nov 2024
DOI:
https://doi.org/10.6004/jnccn.2024.0056
Restricted access

There is an increased risk of infection in patients with cancer that results in higher morbidity and mortality. Several risk factors can predispose these patients to infectious complications. Some such factors include immunocompromised states like neutropenia, allogeneic hematopoietic cell transplantation, and graft-versus-host disease, while others include immunosuppressive agents like corticosteroids, purine analogs, monoclonal antibodies, and other emerging cancer therapeutics like CAR T-cell therapy. The NCCN Guidelines for the Prevention and Treatment of Cancer-Related Infections address infection concerns that may be observed in these immunocompromised populations and characterize the major pathogens to which patients with cancer are susceptible, with a focus on the prevention, diagnosis, and treatment of major common and opportunistic infections. This paper highlights 2 recently updated sections of the guidelines, namely, infection concerns related to CAR T-cell therapy and antimicrobial prophylaxis recommendations, including vaccination, in patients at high-risk for infections.

Discussion Writing Committee Members:

Lindsey Robert Baden, Sankar Swaminathan, Brenda Cooper, Augusto Dulanto Chiang, Zeinab El Boghdadly, Dora Ho, Jennifer Saullo, Susan K. Seo, Carly J. Cassara, Rashmi Kumar, and Zeenat Diwan

To view disclosures of external relationships for the NCCN Guidelines panel, go to https://www.nccn.org/guidelines/guidelines-panels-and-disclosure/disclosure-panels

The full NCCN Guidelines for Prevention and Treatment of Cancer-Related Infections are not printed in this issue of JNCCN. The complete and most recent version of these guidelines is available free of charge at NCCN.org.

NCCN CATEGORIES OF EVIDENCE AND CONSENSUS

Category 1: Based upon high-level evidence (≥1 randomized phase 3 trials or high-quality, robust meta-analyses), there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate.

Category 2A: Based upon lower-level evidence, there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate.

Category 2B: Based upon lower-level evidence, there is NCCN consensus (≥50%, but <85% support of the Panel) that the intervention is appropriate.

Category 3: Based upon any level of evidence, there is major NCCN disagreement that the intervention is appropriate.

All recommendations are category 2A unless otherwise indicated.

NCCN CATEGORIES OF PREFERENCE

Preferred intervention: Interventions that are based on superior efficacy, safety, and evidence; and, when appropriate, affordability.

Other recommended intervention: Other interventions that may be somewhat less efficacious, more toxic, or based on less mature data; or significantly less affordable for similar outcomes.

Useful in certain circumstances: Other interventions that may be used for selected patient populations (defined with recommendation).

All recommendations are considered appropriate.

NCCN recognizes the importance of clinical trials and encourages participation when applicable and available.

Trials should be designed to maximize inclusiveness and broad representative enrollment.

PLEASE NOTE

The NCCN Guidelines® are a statement of evidence and consensus of the authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult the NCCN Guidelines® is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network® (NCCN®) makes no representations or warranties of any kind regarding their content, use, or application and disclaims any responsibility for their application or use in any way.

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Print ISSN:
1540-1405
Online ISSN:
1540-1413
Publisher:
National Comprehensive Cancer Network
Cover Journal of the National Comprehensive Cancer Network
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