2012 ASCO:癌症或接受造血干细胞移植手术的儿童中性粒细胞减少伴发热管理指南

2012-09-17 美国临床肿瘤学会 JCO,2012 Sep. 17

中文标题:

2012 ASCO:癌症或接受造血干细胞移植手术的儿童中性粒细胞减少伴发热管理指南

英文标题:

Guideline for the Management of Fever and Neutropenia in Children With Cancer and/or Undergoing Hematopoietic Stem-Cell Transplantation

发布机构:

美国临床肿瘤学会

发布日期:

2012-09-17

简要介绍:

粒缺伴发热时经化疗后的癌症儿童常见事件,本指南提供了粒缺伴发热的起始症状,管理进展以及抗真菌治疗的推荐建议。文章相关评论见:http://jco.ascopubs.org/content/30/35/4292?etocFebrile neutropenia (FN) is a common adverse event in children with cancer who receive chemotherapy. The guideline provides recommendations on the initial presentation, ongoing management and empiric antifungal treatment of pediatric febrile neutropeniaThe ASCO ad hoc guideline review panel has reviewed the International Pediatric Fever and Neutropenia Guideline Panel for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation and endorses the adoption of the guideline.PurposeTo develop an evidence-based guideline for the empiric management of pediatric fever and neutropenia (FN).MethodsThe International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group composed of experts in pediatric oncology and infectious disease as well as a patient advocate. The Panel was convened for the purpose of creating this guideline. We followed previously validated procedures for creating evidence-based guidelines. Working groups focused on initial presentation, ongoing management, and empiric antifungal therapy. Each working group developed key clinical questions, conducted systematic reviews of the published literature, and compiled evidence summaries. The Grades of Recommendation Assessment, Development, and Evaluation approach was used to generate summaries, and evidence was classified as high, moderate, low, or very low based onmethodologic considerations.ResultsRecommendations were made related to initial presentation (risk stratification, initial evaluation, and treatment), ongoing management (modification and cessation of empiric antibiotics), and empiric antifungal treatment (risk stratification, evaluation, and treatment) of pediatric FN.For each recommendation, the strength of the recommendation and level of evidence are presented.ConclusionThis guideline represents an evidence-based approach to FN specific to children with cancer. Although some recommendations are similar to adult-based guidelines, there are key distinctions in multiple areas. Implementation will require adaptation to the local context.

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    资料好好,但无法分享,遗憾!

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