Safety of early hospital discharge of selected febrile children and adolescents with cancer with prolonged neutropenia

✍ Scribed by Aquino, Victor M.; Buchanan, George R.; Tkaczewski, Isabelle; Mustafa, Mahmoud M.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 44 KB
• Volume: 28
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/(sici)1096-911x(199703)28:3<191::aid-mpo7>3.0.co;2-e

✦ Synopsis

Problem. The safety of early hospital dis-penia had persisted for more than 7 days were charge (i.e., before the absolute neutrophil discharged before attaining an ANC greater than count [ANC] exceeds 500 cell/mm 3 ) of febrile 500/mm 3 when they met the early discharge neutropenic children and adolescents with can-criteria. Only two children (6%) required readcer who had experienced prolonged neutro-mission for recurrent fever, a rate which was not penia (i.e., for more than 7 days) following ad-different from that of patients discharged after mission has not been studied.

a more transient episode of neutropenia (2 of Method of Study. Three hundred and thirty-33 vs. 3 of 121, P ϭ 0.3). Both patients who nine consecutive admissions of children and ad-were readmitted had a source of local infection olescents with cancer for management of febrile which worsened despite oral antibiotics. Both neutropenia were reviewed. Early discharge cri-patients appeared clinically well at the time of teria included absence of fever for 24 hours prior readmission and had sterile cultures during their to discharge, sterile blood cultures for 24 hours, second hospitalization with resolution of local evidence of bone marrow recovery defined as infection. a sustained increase in platelet count and ANC Conclusion. This study confirms that low-risk or absolute phagocyte count (APC), and control criteria used to select children with cancer for of local infection if present. Children hospital-discharge before complete resolution of neutroized with febrile neutropenia who remained penia can be safely applied to those patients neutropenic for more than 7 days were analyzed whose neutropenia lasted more than 7 days to assess their outcomes following discharge if following admission. Med. Pediatr. Oncol. 28: they had met criteria for early hospital discharge. 191-195 ᮊ 1997 Wiley-Liss, Inc. Results. Thirty-three patients inwhom neutro-