Approach to treatment of the febrile cancer patient with low-risk neutropenia

Abstract

All cancer patients who develop fever during a period of neutropenia are not at high risk of developing serious infection. Following hospitalization for empiric broad spectrum antibiotic therapy, certain low-risk patients can be identified and safely be discharged "early", prior to recovery of the absolute neutrophil count to 500 cells per mm3. The medical, psychological, and financial benefits of early hospital discharge are immense. Careful examination for serial increases in components of the peripheral blood count herald marrow recovery and help identify the low-risk patient. It may also be possible to identify "low-risk" neutropenic patients upon development of fever in order to explore alternative management strategies (for example, outpatient oral or intravenous antibiotics) rather than routine hospitalization.