Risk stratification in febrile neutropenic episodes in adolescent/young adult patients with cancer

Phillips, Bob; Bhuller, Kaljit; Sung, Lillian; Ammann, Roland A.; Tissing, Wim J. E.; Lehrnbecher, Thomas; Stewart, Lesley

doi:10.1016/j.ejca.2016.05.027

Cited by 18 publications

(19 citation statements)

References 22 publications

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“…Adolescents, aged 15–19 at diagnosis, experienced a higher rate of infection‐related death compared with other age groups. Teenage cancer patients differ from both younger children and adults with respect to a variety of physiological, social, and psychological issues . Adolescents with cancer have demonstrated more toxicity than younger children receiving similar treatments, often receive more intensive therapy than older adults, and have a higher risk of death than other age groups .…”

Section: Discussionmentioning

confidence: 99%

Infection‐related mortality in Hispanic and non‐Hispanic children with cancer

Smits-Seemann

Pettit

et al. 2017

Pediatric Blood & Cancer

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Section: Discussionmentioning

confidence: 99%

Infection‐related mortality in Hispanic and non‐Hispanic children with cancer

Smits-Seemann

Pettit

et al. 2017

Pediatric Blood & Cancer

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“…There are at least 25 different paediatric clinical decision rules for the assessment of FN. These require local calibration before implementation, and lack of discriminatory value in the adolescents and young adult (AYA) group suggests this group may need its own risk prediction model …”

Section: Introductionmentioning

confidence: 99%

Updated systematic review and meta‐analysis of the predictive value of serum biomarkers in the assessment and management of fever during neutropenia in children with cancer

Arif

Phillips

2019

Pediatric Blood & Cancer

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Routinely measurable biomarkers as predictors for adverse outcomes in febrile neutropenia could improve management through risk stratification. This systematic review assesses the predictive role of biomarkers in identifying events such as bacteraemia, clinically documented infections, microbiologically documented infection, severe sepsis requiring intensive care or high dependency care and death. This review collates 8319 episodes from 4843 patients. C-reactive protein (CRP), interleukin (IL)-6, IL-8 and procalcitonin (PCT) consistently predict bacteraemia and severe sepsis; other outcomes have highly heterogeneous results. Performance of the biomarkers at admission using different thresholds demonstrates that PCT > 0.5 ng/mL offers the best compromise between sensitivity and specificity: sensitivity 0.67 (confidence interval [CI] 0.53-0.79) specificity 0.73 . Seventeen studies describe the use of serial biomarkers, with PCT having the greatest discriminatory role. Biomarkers, potentially with serial measurements, may predict adverse outcomes in paediatric febrile neutropenia and their role in risk stratification is promising.

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“…So far, only a few case reports of severe neutropenia or agranulocytosis during PPI use (ie, omeprazole) have been published. [23][24][25] The suggested pathomechanisms of neutropenia includes immune reactions and cross--reactivity. Also, synergic reactions with other potential causes of neutropenia should be considered.…”

Section: Resultsmentioning

confidence: 99%

Effect of chronic proton pump inhibitor therapy on complete blood count parameters and selected trace elements – pilot study

Kaczmarczyk¹,

Przybylska-Feluś

Piątek-Guziewicz

et al. 2019

Polish Archives of Internal Medicine

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INTROduCTION Proton pump inhibitors (PPIs) are widely prescribed for several gastrointestinal conditions, often as long-term therapy. The effects of long-term PPI use have not been fully elucidated. ObjECTIvEs We aimed to determine the association between long-term PPI use and complete blood count parameters, particularly red blood cell (RBC) count, white blood cell (WBC) count, and hemoglobin concentrations, as well as serum levels of selected micronutrients such as selenium (Se), iron (Fe), copper (Cu), and zinc (Zn). PATIENTs ANd mEThOds We enrolled 37 patients on long-term PPI therapy (mean [SD] age, 57.1 [15.4] years) and 30 healthy controls (mean [SD] age, 39.3 [11.8] years). In each group, complete blood count, and serum Fe levels were performed, and serum Cu, Zn, and Se levels were measured using atomic absorption spectrometry. REsuLTs Red blood cell and WBC counts were lower in the PPI group compared with controls (mean [SD], 4.24 [0.55] ×10 6 /μl vs 4.7 [0.4] ×10 6 /μl; P <0.001 and 6.13 [1.44] ×10 3 /μl vs 7.3 [1.28] ×10 3 /μl; P <0.001, respectively). Hemoglobin and serum Fe concentrations were also lower in the PPI group (mean [SD], 12.5 [1.8] g/dl vs 14.3 [0.8] g/dl; P <0.001 and 16.3 [5.4] μmol/l vs 23.4 [2.7] μmol/l; P <0.001, respectively). Serum Zn and Cu concentrations were higher in PPI users than in controls. CONCLusIONs Long-term PPI therapy may reduce RBC and WBC counts as well as hemoglobin levels, leading to iron deficiency. It may also affect concentrations of some micronutrients, although the underlying mechanism of this association is not fully clear. EdITORIAL by Higuchi, see p. 174

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Risk stratification in febrile neutropenic episodes in adolescent/young adult patients with cancer

Cited by 18 publications

References 22 publications

Infection‐related mortality in Hispanic and non‐Hispanic children with cancer

Infection‐related mortality in Hispanic and non‐Hispanic children with cancer

Updated systematic review and meta‐analysis of the predictive value of serum biomarkers in the assessment and management of fever during neutropenia in children with cancer

Effect of chronic proton pump inhibitor therapy on complete blood count parameters and selected trace elements – pilot study

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