GuidelineJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update.
Guideline in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07590648 (Phase IV, Randomized, Open Label, Parallel Groups Clinical Trial for Evaluating the Early Stop of Antibiotic Treatment in High-risk Febrile Neutropenic Oncohaematological Paediatric Patients), which is not on this map. Cited by 97 papers, 2 of them syntheses 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.
Phase IV, Randomized, Open Label, Parallel Groups Clinical Trial for Evaluating the Early Stop of Antibiotic Treatment in High-risk Febrile Neutropenic Oncohaematological Paediatric Patients (e-STOP 2)
Who cites it
97 citing papers in PubMed, 2 syntheses or guidelines pooled it, 159 citations in OpenAlex.
- Association of Time to Antibiotics With Outcome in Pediatric Patients Receiving Chemotherapy for Cancer With Fever in Neutropenia-An International Individual Patient Data Meta-Analysis.Cancer medicine · 2026Pooled it
- Best Practice Considerations by The American Society of Transplant and Cellular Therapy: Infection Prevention and Management After Chimeric Antigen Receptor T Cell Therapy for Hematological Malignancies.Transplantation and cellular therapy · 2024Guideline
- Continuous infusion of granulocyte colony-stimulating factor is associated with an advantage in neutrophil recovery in pediatric oncologic disorders.Cancer chemotherapy and pharmacology · 2026Trial
- Factors associated with unplanned healthcare encounters in pediatric cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Comparison of 2-hour drip infusions of meropenem versus piperacillin/tazobactam for febrile neutropenia in pediatric patients.Antimicrobial agents and chemotherapy · 2025Trial
- Development and preliminary validation of the Exercise Fit Tool for adolescents undergoing cancer treatment in Hong Kong.Asia-Pacific journal of oncology nursing · 2026Article
- Efficacy and Safety of Adjusting Antimicrobial Therapy in Episodes of Fever and Neutropenia Catalogued as Fever of Unknown Origin in Children with Cancer: A Randomized Clinical Trial.Antibiotics (Basel, Switzerland) · 2026Article
- Bacterial bloodstream infections in pediatric oncology patients in a tertiary medical center: pathogen distribution, antimicrobial nonsusceptibility, and outcomes.European journal of pediatrics · 2026Article
- Impact of an antimicrobial stewardship intervention on carbapenem use in children with cancer.Infection · 2026Article
- Prophylactic PEG-rhG-CSF Reduces Febrile Neutropenia in Pediatric Hematological Malignancies Compared with Daily rhG-CSF.Cancers · 2026Article
- Clinical Characteristics of Carbapenem-Resistant Gram-Negative Bloodstream Infections and Fungemia Among High-Risk Pediatric Patients Receiving Empirical Antifungal Therapy.Pathogens (Basel, Switzerland) · 2026Observational
- Combination Antifungal Therapy and Formulary Optimization for Progressive Invasive Pulmonary Aspergillosis in a Pediatric Patient With Acute Myeloid Leukemia: A Case Report.Clinical case reports · 2026Article
- Process Analysis of Time to Antibiotics in Pediatric Patients With Fever in Neutropenia During Chemotherapy for Cancer.Journal of pediatric hematology/oncology · 2026Article
- Palatal Perforation as a Rare Presentation of Severe Congenital Neutropenia Due to an ELANE Mutation.Cureus · 2026Article
- Factors associated with persistent postoperative hyperthermia in pediatric craniocerebral injury: a retrospective cohort study and preliminary risk score.Perioperative medicine (London, England) · 2026Article
- Multidrug-Resistant Gram-Negative Bacteremia among Pediatric Oncology Patients with Neutropenic Fever: Associated Risk Factors and Mortality Outcomes.Infection & chemotherapy · 2026Article
- CARE study: prospective cohort study on supportive care among paediatric oncology patients in western Kenya-a study protocol.BMJ open · 2026Article
- Bacteremia by viridans group streptococci in children with leukemia: Epidemiology and variables associated with recurrenceBiomedica : revista del Instituto Nacional de Salud · 2026Article
- Predicting bloodstream infection by plasma cell-free metagenomic sequencing: a prospective cohort study.The Lancet. Microbe · 2026Observational
- Impact of Routine Respiratory Pathogen Panel Test on Outcome of Pediatric Oncology Patients With Febrile Neutropenia.Cancer reports (Hoboken, N.J.) · 2026Article
37 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
21 authors at 14 institutions in 10 countries.
Funding
Abstract
purposeTo update a clinical practice guideline (CPG) for the empiric management of fever and neutropenia (FN) in pediatric patients with cancer and hematopoietic cell transplantation recipients.
methodsThe International Pediatric Fever and Neutropenia Guideline Panel reconvened to conduct the second update of this CPG. We updated the previous systematic review to identify new randomized controlled trials (RCTs) evaluating any strategy for the management of FN in pediatric patients. Using the Grading of Recommendations Assessment, Development and Evaluation framework, evidence quality was classified as high, moderate, low, or very low. The panel updated recommendations related to initial management, ongoing management, and empiric antifungal therapy. Changes from the 2017 CPG were articulated, and good practice statements were considered.
resultsWe identified 10 new RCTs in addition to the 69 RCTs identified in previous FN CPGs to inform the 2023 FN CPG. Changes from the 2017 CPG included two conditional recommendations regarding (1) discontinuation of empiric antibacterial therapy in clinically well and afebrile patients with low-risk FN if blood cultures remain negative at 48 hours despite no evidence of marrow recovery and (2) pre-emptive antifungal therapy for invasive fungal disease in high-risk patients not receiving antimold prophylaxis. The panel created a good practice statement to initiate FN CPG-consistent empiric antibacterial therapy as soon as possible in clinically unstable febrile patients.
conclusionThe updated FN CPG incorporates important modifications on the basis of recently published trials. Future work should focus on addressing knowledge gaps, improving CPG implementation, and measuring the impact of CPG-consistent care.
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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.