Risk Assessment in Adult Cancer Patients with Febrile Neutropenia: A Review of Methods and of Risk-adapted Empiric Treatments

Abstract

Febrile neutropenia is a common complication of antineoplasic chemotherapy. It is a potentially serious event, sometimes lethal. However, it is well recognized that the population of patients with febrile neutropenia is heterogeneous in terms of prognosis. Simplified therapy, for instance oral antibiotic empiric treatment or ambulatory treatment, in comparison to the classical management of intravenously administered empiric antibiotics and in-hospital surveillance, has been the purpose of research for patients predicted at low-risk for serious complications development. However, for such a strategy to be successful an accurate identification of patients at low-risk is required. The objective of the present review is to present the available tools for risk assessment, in adult patients populations and to review the status of our knowledge regarding the efficacy and the safety of risk-adapted therapy.