Predicting adverse events in children with fever and chemotherapy-induced neutropenia: the prospective multicenter SPOG 2003 FN study.

Détails

ID Serval
serval:BIB_771853C96594
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Predicting adverse events in children with fever and chemotherapy-induced neutropenia: the prospective multicenter SPOG 2003 FN study.
Périodique
Journal of clinical oncology
Auteur(s)
Ammann R.A., Bodmer N., Hirt A., Niggli F.K., Nadal D., Simon A., Ozsahin H., Kontny U., Kühne T., Popovic M.B., Lüthy A.R., Aebi C.
ISSN
1527-7755 (Electronic)
ISSN-L
0732-183X
Statut éditorial
Publié
Date de publication
20/04/2010
Peer-reviewed
Oui
Volume
28
Numéro
12
Pages
2008-2014
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Résumé
PURPOSE To develop a score predicting the risk of adverse events (AEs) in pediatric patients with cancer who experience fever and neutropenia (FN) and to evaluate its performance. PATIENTS AND METHODS Pediatric patients with cancer presenting with FN induced by nonmyeloablative chemotherapy were observed in a prospective multicenter study. A score predicting the risk of future AEs (ie, serious medical complication, microbiologically defined infection, radiologically confirmed pneumonia) was developed from a multivariate mixed logistic regression model. Its cross-validated predictive performance was compared with that of published risk prediction rules. Results An AE was reported in 122 (29%) of 423 FN episodes. In 57 episodes (13%), the first AE was known only after reassessment after 8 to 24 hours of inpatient management. Predicting AE at reassessment was better than prediction at presentation with FN. A differential leukocyte count did not increase the predictive performance. The score predicting future AE in 358 episodes without known AE at reassessment used the following four variables: preceding chemotherapy more intensive than acute lymphoblastic leukemia maintenance (weight = 4), hemoglobin > or = 90 g/L (weight = 5), leukocyte count less than 0.3 G/L (weight = 3), and platelet count less than 50 G/L (weight = 3). A score (sum of weights) > or = 9 predicted future AEs. The cross-validated performance of this score exceeded the performance of published risk prediction rules. At an overall sensitivity of 92%, 35% of the episodes were classified as low risk, with a specificity of 45% and a negative predictive value of 93%. CONCLUSION This score, based on four routinely accessible characteristics, accurately identifies pediatric patients with cancer with FN at risk for AEs after reassessment.

Mots-clé
Antineoplastic Agents/adverse effects, Child, Child, Preschool, Female, Fever/blood, Fever/chemically induced, Fever/complications, Fever/diagnosis, Germany, Hemoglobins/metabolism, Humans, Leukocyte Count, Logistic Models, Male, Neutropenia/blood, Neutropenia/chemically induced, Neutropenia/complications, Neutropenia/diagnosis, Platelet Count, Predictive Value of Tests, Prognosis, Prospective Studies, Reproducibility of Results, Risk Assessment, Risk Factors, Sensitivity and Specificity, Severity of Illness Index, Switzerland
Pubmed
Web of science
Création de la notice
06/05/2010 15:01
Dernière modification de la notice
03/03/2018 18:27
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