Abstract

Suhag V., Sunita B.S., Sarin A., Dutta V., Singh A.K., Goyal P. and Dubey A.P.

ABSTRACT

Febrile neutropenia (FN) is a frequent, serious complication of intensive chemotherapy regimens both in hematology and solid cancers. Fever during chemotherapy-induced neutropenia may be the only indication of a severe underlying infection, because signs and symptoms of inflammation typically are attenuated. It is critical to recognize neutropenic fever early and to initiate empiric systemic antibacterial therapy promptly in order to avoid progression to a sepsis syndrome and possibly death. Due to the potential for life-threatening complications, the development of FN in patients receiving cancer chemotherapy traditionally prompted hospitalization and i.v. antimicrobial therapy, but there is convincing published evidence that an identifiable subset of patients can be safely treated as outpatients. It is crucial to assess the risk of serious complications in patients with neutropenic fever, since this assessment will dictate the approach to therapy, including the need for inpatient admission, intravenous (IV) antibiotics, and prolonged hospitalization. High-risk neutropenic patients are those with an absolute neutrophil count (ANC) 7 days or evidence of ongoing comorbid conditions. Despite major advances in prevention and treatment, febrile neutropenia (FN) remains one of the most concerning complications of cancer chemotherapy, and is a major cause of morbidity, healthcare resource use and compromised efficacy resulting from delays and dose reductions in chemotherapy. Here we review the latest recommendations for management oof FN; issued by Infectious Diseases Society of America (IDSA), European Society for Medical Oncology (ESMO) and National Comprehensive Cancer Network (NCCN); which are considered standard of care in Oncology practices.