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Michael Kleinberg
. 4 Bodey GP Rodriguez V Chang HY . Fever and infection in leukemic patients . Cancer 1978 ; 41 : 1610 - 1622 . 5 Cruciani M Rampazzo R Malena M . Prophylaxis with fluoroquinolones for bacterial infections in neutropenic patients: A
Eric J Roeland, Thomas W. LeBlanc, Kathryn J. Ruddy, Ryan Nipp, Rebecca Clark-Snow, Rita Wickham, Gary Binder, William L. Bailey, Ravi Potluri, Luke M. Schmerold, Eros Papademetriou, and Rudolph M. Navari
identified rates of IP/ED ≤30 days post-chemotherapy, and OP-35 toxicities (NV, anemia, dehydration, diarrhea, fever, neutropenia, pain, pneumonia, or sepsis) by ICD-9, ICD-10, procedure codes, and CMS criteria. We evaluated cisplatin, anthracycline
William Alegria, Bernard L. Marini, Kevin Sellery Gregg, Dale Lee Bixby, Anthony Perissinotti, and Jerod Nagel
/causative pathogen, and resolution of fever ( Figure 1 ). To proceed with antibiotic de-escalation, patients needed to be afebrile for a minimum of 48 hours and clinically stable as determined by the treating physician. Patients meeting criteria for de
Vijaya Raj Bhatt, R. Gregory Bociek, Ji Yuan, Kai Fu, Timothy C. Greiner, Bhavana J. Dave, Sandeep K. Rajan, and James O. Armitage
to the University of Nebraska Medical Center (UNMC) for multiple episodes of epistaxis; skin bruises; intermittent fevers; fatigue; anorexia; a few episodes of diarrhea; and dyspnea during the preceding week. At the referring institution, he was found
Memorial Sloan-Kettering Cancer Center
Infectious diseases are important causes of morbidity and mortality in patients with cancer. In certain instances, the malignancy itself can predispose patients to severe or recurrent infections. Neutropenia has been recognized for many decades as a major risk factor, and effective strategies to anticipate, prevent, and manage infectious complications in patients with cancer experiencing neutropenia have led to improved outcomes. Reflecting the heterogeneity of immunocompromised conditions in patients with cancer and the spectrum of pathogens to which they are susceptible, NCCN expanded the scope of the Fever and Neutropenia Panel in 2007 to create guidelines on Prevention and Treatment of Cancer-Related Infections. These guidelines, newly updated for 2008, characterize major categories of immunologic deficits in persons with cancer and the major pathogens to which they are susceptible.
For the most recent version of the guidelines, please visit NCCN.org
Michaela A. Dinan, Bradford R. Hirsch, and Gary H. Lyman
Treatment-associated neutropenia continues to represent the most common dose-limiting toxicity of cancer chemotherapy. It often leads to fever and infection, prompting hospitalization and occasionally resulting in serious morbidity, and even mortality, despite modern broad-spectrum antibiotic treatment and supportive care. Neutropenia and its complications may also lead to chemotherapy dose reductions, treatment delays, or early treatment termination, compromising disease control and the potential for cure. NCCN Clinical Practice Guidelines in Oncology recommend administration of primary prophylaxis with a myeloid growth factor in patients receiving regimens associated with a high risk for febrile neutropenia, and consideration of prophylaxis in patients receiving lower-risk regimens who have other risk factors that might place them at higher risk for febrile neutropenia. Although these agents have been shown to be effective and safe in numerous randomized controlled trials, they are expensive and contribute significantly to increasing health care costs. Regulatory agencies and guideline organizations do not currently address the issue of cost. However, with the relentless increase in health care use and current efforts to reform health care, it has become increasingly important to assess both the cost and the net benefit of interventions related to an episode of care in order to compare the overall value of therapeutic options. This article defines and discusses the intersection of quality, costs, and value in the context of prophylactic myeloid growth factor use in patients with cancer receiving myelosuppressive chemotherapy.
Weijia Wang, Edward Li, Kim Campbell, and Ali McBride
prophylaxis date. FN was defined using claims with a diagnosis code for neutropenia (main definition), neutropenia with fever or infection (sensitive definition) and neutropenia with fever (specific definition). FN incidence among the first chemotherapy cycle
Wenhui Li, Katherine Simondsen, Katherine Tobon, Kevin McCarthy, and Timothy Kubal
incidence of neutropenic fever, extravasations, drug spills, pump-malfunctions, and drug-related adverse events. Financial data was conducted through the institution’s financial department. Results: 88% (193 of 219) of DA-EPOCH cycles were administered
-cell transplant experience. Close monitoring in the hospital...” ➤ 2nd bullet was revised: “Hospitalization is warranted for patients with at the first sign of CRS or neurotoxicity (including fever, hypotension, or change in mental status) is warranted
