Defined as a fever >38°C (>101°F) for 1 hour, with an absolute neutrophil count (ANC) of ≤500 cells/microlitre, or an ANC ≤1000 cells/microlitre with a projected nadir of ≤500 cells/microlitre.
It is the most common life-threatening complication of cancer therapy and is an oncological emergency.
Empirical antibiotic therapy upon presentation has dramatically improved outcomes and decreased mortality from febrile neutropenia.
A causative organism is only identified one third of the time, and therefore antibiotics are aimed at treating a broad spectrum of pathogens.
Due to an inability to mount an inflammatory response, many patients with febrile neutropenia do not demonstrate localising signs or symptoms other than fever.
Prophylactic antibiotics and growth factor support at the onset of neutropenia have only been shown to benefit a small subgroup of cancer patients receiving chemotherapy.
Febrile neutropenia is defined as a fever >38°C (>101°F) for 1 hour, with an absolute neutrophil count (ANC) of ≤500 cells/microlitre, or an ANC of ≤1000 cells/microlitre with a projected nadir of ≤500 cells/microlitre.
Instructor in Medicine
Dana Farber Cancer Institute
CJ declares that she has no competing interests.
Dr Caron Jacobson would like to gratefully acknowledge Dr Joseph Antin, a previous contributor to this monograph. JA declares that he has no competing interests.
Price Eminent Scholar and Professor of Medicine
Bone Marrow Transplant Program
Division of Hematology/Oncology
University of Florida College of Medicine
JW has been reimbursed by Pfizer, Merck, Astellas, and Enzon for speaking fees, fees for educational programs, and consulting.
Alfa Institute of Biomedical Sciences
MF declares that he has no competing interests.
Senior Lecturer in Haematology
Honorary Consultant in Medical Oncology
St George's University of London
RP has received speaker fees and been reimbursed by Roche, Amgen, Chigai, and Bayer for attending several conferences. RP is a co-author of the EORTC guidelines referenced in this monograph.
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