The need for evolution in the management of febrile neutropenia in pediatric cancer: TRIIO KIDS update

Clin Transl Oncol. 2023 Mar;25(3):633-642. doi: 10.1007/s12094-022-02971-z. Epub 2022 Oct 16.

Abstract

New treatments have increased the life expectancy of pediatric patients diagnosed with malignant hematological diseases, often at the cost of protracting their immunocompromised state in the form of prolonged neutropenia. This neutropenic state favors the development of bacterial and fungal infections. Moreover, recent years have seen a series of changes in the epidemiology of fungal and Clostridium infections. These changes necessitate adaptations to the management of pediatric patients with febrile neutropenia, who are at risk of further increases in already high rates of morbidity and mortality. This article discusses the current bases for the management of febrile neutropenia and associated emerging fungal infections, as well as the epidemiology, diagnosis, and treatment of Clostridioides difficile in pediatric patients diagnosed with malignant hematological diseases.

Keywords: Clostridioides difficile infection; Emerging fungal infections; Febrile neutropenia; Malignant hematological diseases.

MeSH terms

  • Anti-Bacterial Agents
  • Child
  • Febrile Neutropenia* / etiology
  • Febrile Neutropenia* / therapy
  • Humans
  • Leukopenia*
  • Mycoses* / chemically induced
  • Mycoses* / drug therapy
  • Mycoses* / epidemiology
  • Neoplasms* / complications
  • Neoplasms* / therapy

Substances

  • Anti-Bacterial Agents