PMID- 20231680 OWN - NLM STAT- MEDLINE DCOM- 20100430 LR - 20191210 IS - 1527-7755 (Electronic) IS - 0732-183X (Linking) VI - 28 IP - 12 DP - 2010 Apr 20 TI - Predicting adverse events in children with fever and chemotherapy-induced neutropenia: the prospective multicenter SPOG 2003 FN study. PG - 2008-14 LID - 10.1200/JCO.2009.25.8988 [doi] AB - 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. FAU - Ammann, Roland A AU - Ammann RA AD - Pediatric Hematology/Oncology, University of Bern, Inselspital, CH-3010 Bern, Switzerland. roland.ammann@insel.ch FAU - Bodmer, Nicole AU - Bodmer N FAU - Hirt, Andreas AU - Hirt A FAU - Niggli, Felix K AU - Niggli FK FAU - Nadal, David AU - Nadal D FAU - Simon, Arne AU - Simon A FAU - Ozsahin, Hulya AU - Ozsahin H FAU - Kontny, Udo AU - Kontny U FAU - Kuhne, Thomas AU - Kuhne T FAU - Popovic, Maja Beck AU - Popovic MB FAU - Luthy, Annette Ridolfi AU - Luthy AR FAU - Aebi, Christoph AU - Aebi C LA - eng PT - Evaluation Study PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20100315 PL - United States TA - J Clin Oncol JT - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JID - 8309333 RN - 0 (Antineoplastic Agents) RN - 0 (Hemoglobins) SB - IM CIN - J Clin Oncol. 2011 Mar 1;29(7):e182-4; author reply e185. PMID: 21245423 MH - Antineoplastic Agents/*adverse effects MH - Child MH - Child, Preschool MH - Female MH - Fever/blood/*chemically induced/complications/*diagnosis MH - Germany MH - Hemoglobins/metabolism MH - Humans MH - Leukocyte Count MH - Logistic Models MH - Male MH - Neutropenia/blood/*chemically induced/complications/*diagnosis MH - Platelet Count MH - Predictive Value of Tests MH - Prognosis MH - Prospective Studies MH - Reproducibility of Results MH - Risk Assessment MH - Risk Factors MH - Sensitivity and Specificity MH - Severity of Illness Index MH - Switzerland EDAT- 2010/03/17 06:00 MHDA- 2010/05/01 06:00 CRDT- 2010/03/17 06:00 PHST- 2010/03/17 06:00 [entrez] PHST- 2010/03/17 06:00 [pubmed] PHST- 2010/05/01 06:00 [medline] AID - JCO.2009.25.8988 [pii] AID - 10.1200/JCO.2009.25.8988 [doi] PST - ppublish SO - J Clin Oncol. 2010 Apr 20;28(12):2008-14. doi: 10.1200/JCO.2009.25.8988. Epub 2010 Mar 15.