©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Aug 25, 2016; 6(3): 37-60
Published online Aug 25, 2016. doi: 10.5495/wjcid.v6.i3.37
Published online Aug 25, 2016. doi: 10.5495/wjcid.v6.i3.37
Clinical research in febrile neutropenia in cancer patients: Past achievements and perspectives for the future
Jean Klastersky, Marianne Paesmans, Michel Aoun, Aspasia Georgala, Angela Loizidou, Yassine Lalami, Lissandra Dal Lago, Institut Jules Bordet, Service de Médecine, Centre des Tumeurs de l’Université Libre de Bruxelles, 1000 Brussels, Belgium
Author contributions: Klastersky J contributed to historical background and introduction; Paesmans M contributed to risk prediction for complications and death; Klastersky J contributed to prevention according to risk; Aoun M contributed to empiric therapy according to risk; Georgala A contributed to emergence of resistant strains; Loizidou A contributed to persisting febrile neutropenia; Lalami Y contributed to cost issues; Dal Lago L contributed to febrile neutropenia at the extreme of age; Klastersky J and Aoun M contributed to conclusion.
Conflict-of-interest statement: None of the authors has any conflict of interest.
Correspondence to: Jean Klastersky, MD, PhD, Institut Jules Bordet, Service de Médecine, Centre des Tumeurs de l’Université Libre de Bruxelles, 1, rue Héger-Bordet, 1000 Brussels, Belgium. jean.klastersky@bordet.be
Telephone: +32-2-5417396 Fax: +32-2-5380858
Received: June 30, 2015
Peer-review started: July 6, 2015
First decision: September 30, 2015
Revised: April 25, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 25, 2016
Processing time: 421 Days and 11.6 Hours
Peer-review started: July 6, 2015
First decision: September 30, 2015
Revised: April 25, 2016
Accepted: June 1, 2016
Article in press: June 3, 2016
Published online: August 25, 2016
Processing time: 421 Days and 11.6 Hours
Core Tip
Core tip: The overall presentation of febrile neutropenia has considerably changed over the last 50 years. Prevention is now feasible with the use of granulocyte colony stimulating factors. If fever appears in a neutropenic patient, empirical therapy with broad spectrum antibiotics is mandatory; it should be adapted to the risk of severe complications that can be now predicted in individual patients using a reliable scoring system. Special situations such as persisting fever in neutropenic patients, the risk of invasive fungal infection and the management of older patients are crucial questions that are discussed as well as the issues linked to the high cost of prophylaxis and therapy.