SynthesisSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2016
Systematic review of reduced therapy regimens for children with low risk febrile neutropenia.
Synthesis in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Meta-ethnography of experiences of early discharge, with a focus on paediatric febrile neutropenia.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2018Pooled it
- Clinical Phenotypes and Glycopeptide Escalation Patterns in Pediatric Febrile Neutropenia: Associations with Short-Term Outcomes and Acute Kidney Injury RiskTurkish journal of haematology : official journal of Turkish Society of Haematology · 2026Article
- Clinical practice guideline- and care pathway-inconsistent care following implementation of adapted infection management care pathways.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- "Better at home": Mixed methods report of intricacies in pediatric febrile neutropenia management.Cancer medicine · 2024Article
- Can I go home now? The safety and efficacy of a new UK paediatric febrile neutropenia protocol for risk-stratified early discharge on oral antibiotics.Archives of disease in childhood · 2023Article
- Internal evaluation of risk stratification tool using serial procalcitonin and clinical risk factors in pediatric febrile neutropenia: The non-interventional, single institution experience prior to clinical implementation.Pediatric hematology and oncology · 2023Article
- Article
- Managing low-risk febrile neutropenia in children in the time of COVID-19: What matters to parents and clinicians.Journal of paediatrics and child health · 2021Article
- Home-based care of low-risk febrile neutropenia in children-an implementation study in a tertiary paediatric hospital.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Optimising Antimicrobial Selection and Duration in the Treatment of Febrile Neutropenia in Children.Infection and drug resistance · 2021Review
- Management of children with fever and neutropenia: results of a survey in 51 pediatric cancer centers in Germany, Austria, and Switzerland.Infection · 2020Article
- Re-evaluating and recalibrating predictors of bacterial infection in children with cancer and febrile neutropenia.EClinicalMedicine · 2020Article
- Guidance Statement for the Management of Febrile Neutropenia in Pediatric Patients Receiving Cancer-Directed Therapy in Central America and the Caribbean.JCO global oncology · 2020Article
- Risk stratification in children with cancer and febrile neutropenia: A national, prospective, multicentre validation of nine clinical decision rules.EClinicalMedicine · 2020Article
- Protocol for a systematic review of time to antibiotics (TTA) in patients with fever and neutropenia during chemotherapy for cancer (FN) and interventions aiming to reduce TTA.Systematic reviews · 2019Article
- Recent advances in the prevention and management of infections in children undergoing treatment for cancer.F1000Research · 2019Review
- Article
- Pediatric patients at risk for fever in chemotherapy-induced neutropenia in Bern, Switzerland, 1993-2012.Scientific data · 2018Article
- Predicting Infectious ComplicatioNs in Children with Cancer: an external validation study.British journal of cancer · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
purposeReduced intensity therapy for children with low-risk febrile neutropenia may provide benefits to both patients and the health service. We have explored the safety of these regimens and the effect of timing of discharge.
methodsMultiple electronic databases, conference abstracts and reference lists were searched. Randomised controlled trials (RCT) and prospective observational cohorts examining the location of therapy and/or the route of administration of antibiotics in people younger than 18 years who developed low-risk febrile neutropenia following treatment for cancer were included. Meta-analysis using a random effects model was conducted. I (2) assessed statistical heterogeneity not due to chance. REGISTRATION: PROSPERO (CRD42014005817).
resultsThirty-seven studies involving 3205 episodes of febrile neutropenia were included; 13 RCTs and 24 prospective observational cohorts. Four safety events (two deaths, two intensive care admissions) occurred. In the RCTs, the odds ratio for treatment failure (persistence, worsening or recurrence of fever/infecting organisms, antibiotic modification, new infections, re-admission, admission to critical care or death) with outpatient treatment was 0.98 (95% confidence interval (95%CI) 0.44-2.19, I (2) = 0 %) and with oral treatment was 1.05 (95%CI 0.74-1.48, I (2) = 0 %). The estimated risk of failure using outpatient therapy from all prospective data pooled was 11.2 % (95%CI 9.7-12.8 %, I (2) = 77.2 %) and using oral antibiotics was 10.5 % (95%CI 8.9-12.3 %, I (2) = 78.3 %). The risk of failure was higher when reduced intensity therapies were used immediately after assessment, with lower rates when these were introduced after 48 hours.
conclusionsReduced intensity therapy for specified groups is safe with low rates of treatment failure. Services should consider how these can be acceptably implemented.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.