Can febrile neutropenia re-invent its self?

IF 2.8 4区 医学 Q2 ONCOLOGY
Current Opinion in Oncology Pub Date : 2025-03-01 Epub Date: 2025-01-15 DOI:10.1097/CCO.0000000000001116
Aspasia Georgala, Jean Klastersky
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引用次数: 0

Abstract

Purpose of review: Febrile neutropenia as a complication of cytotoxic chemotherapies, remains a major event in the medical journey of hematology and oncology patients. In this review, we are trying to review the new elements and highlights that are shaping febrile neutropenia in nowadays.

Recent findings: Introduction of risk-stratification, expanded use of granulocyte-colony stimulating factor and oral treatment for selected patients and rapid administration of antibiotics revolutionized the treatment of febrile neutropenia. Oral treatment with moxifloxacine or amoxicillin-clavulanate + ciprofloxacin has already been widely tested and is actually a standard of care for a meticulously selected group of patients managed as ambulatory patients. Intravenous treatment of febrile neutropenia is a major challenge for clinicians and microbiologists since the blast of the "silent pandemic" of antimicrobial resistance.

Summary: In this setting, strategies that reduce the chances of febrile neutropenia, misuse of antibiotics and enhance the rigorous control of infections may offer a chance to improve the management of febrile neutropenia and offer to our patients the chance to continue their antineoplastic treatment without perturbations.

发热性中性粒细胞减少症能自我改造吗?
回顾目的:发热性中性粒细胞减少症作为细胞毒性化疗的并发症,在血液学和肿瘤学患者的医疗旅程中仍然是一件大事。在这篇综述中,我们试图回顾目前形成发热性中性粒细胞减少症的新因素和重点。最近的发现:引入风险分层,扩大使用粒细胞集落刺激因子和口服治疗选定的患者和快速给药抗生素彻底改变了发热性中性粒细胞减少症的治疗。口服莫西沙星或阿莫西林-克拉维酸+环丙沙星治疗已经进行了广泛的试验,并且实际上是精心挑选的一组作为门诊患者进行管理的患者的标准护理。自从抗菌素耐药性“无声大流行”爆发以来,热性中性粒细胞减少症的静脉治疗是临床医生和微生物学家面临的一项重大挑战。总结:在这种情况下,减少发热性中性粒细胞减少的机会,滥用抗生素和加强严格控制感染的策略可能为改善发热性中性粒细胞减少的管理提供机会,并为我们的患者提供继续抗肿瘤治疗的机会,而不会受到干扰。
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来源期刊
Current Opinion in Oncology
Current Opinion in Oncology 医学-肿瘤学
CiteScore
6.10
自引率
2.90%
发文量
130
审稿时长
4-8 weeks
期刊介绍: With its easy-to-digest reviews on important advances in world literature, Current Opinion in Oncology offers expert evaluation on a wide range of topics from sixteen key disciplines including sarcomas, cancer biology, melanoma and endocrine tumors. Published bimonthly, each issue covers in detail the most pertinent advances in these fields from the previous year. This is supplemented by annotated references detailing the merits of the most important papers.
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