Risk stratification in febrile neutropenic episodes in adolescent/young adult patients with cancer

Autor: Robert S. Phillips, Kaljit Bhuller, Lillian Sung, Roland A. Ammann, Wim J.E. Tissing, Thomas Lehrnbecher, Lesley A. Stewart, Gabrielle M. Haeusler, Tiene Bauters, Geneviève Laureys, Maria Spassova, Robert Klaassen, Sarah Alexander, Pamela Silva, Juan Tordecilla, Marianne Paesmans, J. Peter Donnelly, Arne Simon, Ian M. Hann, Neil Ranasinghe, Richard D. Riley, Julia Chisholm, Daniel Yeomanson, Alex J. Sutton, Rachel Dommett, Ajay Gupta, Elio Castagnola, Ricarrdo Haupt, Karin Meidema, Thomas Kuehne, Lidija Kitanovski, Felix Niggli, David Nadal, Gulsun Tezcan, Hana Hakim, Glen Stryjewski
Přispěvatelé: Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
0301 basic medicine
Cancer Research
Pediatrics
PREDICTION
YOUNG-PEOPLE
CHILDREN
Severity of Illness Index
0302 clinical medicine
Risk Factors
Neoplasms
Adolescent/young adult oncology
Young adult
610 Medicine & health
education.field_of_study
Infectious complications
Age Factors
Disease Management
Bacterial Infections
Oncology
Area Under Curve
030220 oncology & carcinogenesis
Predictive value of tests
Female
Risk assessment
Adult
medicine.medical_specialty
BACTEREMIA
Adolescent
Neutropenic sepsis
Population
Risk Assessment
Sensitivity and Specificity
Decision Support Techniques
Young Adult
03 medical and health sciences
CHEMOTHERAPY-INDUCED NEUTROPENIA
FEVER
Predictive Value of Tests
Severity of illness
medicine
MANAGEMENT
Humans
education
METAANALYSIS
Febrile Neutropenia
ACUTE LYMPHOBLASTIC-LEUKEMIA
Receiver operating characteristic
business.industry
medicine.disease
030104 developmental biology
Bacteremia
business
INDIVIDUAL PARTICIPANT DATA
Febrile neutropenia
Supportive care
Zdroj: European Journal of Cancer, 64, 101-106. ELSEVIER SCI LTD
ISSN: 0959-8049
DOI: 10.1016/j.ejca.2016.05.027
Popis: Background: Risk-stratified management of febrile neutropenia (FN) allows intensive management of high-risk cases and early discharge of low-risk cases. Most risk stratification systems predicting severe infection from admission variables have been derived from childhood or adult populations and consequently their value in adolescents/young adults (AYA) may vary. Our objective was to determine their value in this population.Methods: Data from the 'predicting infectious complications in children with cancer' (PICNICC) individual participant data collaboration were used to evaluate six previously described risk stratification schema in the AYA population. Complete case analyses were undertaken for five 'paediatric' rules, with imputation for specific missing variables of the 'adult' rule. The predictive performance of the rules or the outcome microbiologically defined infection (sensitivity, specificity and predictive values) were compared.Results: Among the 5,127 episodes of FN in 3,504 patients in the PICNICC collaboration data set, 603 episodes of FN from 478 patients in 20 studies were of patients 16-25 years old. The six rules demonstrated variable sensitivity (33-96%) and specificity (13-83%). Their overall discriminatory ability was poor (area under the receiver operator curve estimates 0.514-0.593).Conclusions: Both paediatric and adult FN risk stratification schema perform poorly in AYA with cancer. An alternative rule or clinical recognition of their limitations is required. (C) 2016 Elsevier Ltd. All rights reserved.
Databáze: OpenAIRE
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