Pediatric FN Definition 2012 Bern

Pediatric FN Definition 2012 Bern The Impact of Lowering Fever Limits on the Rate of Fever in Chemotherapy-induced Neutropenia (FN). A Prospective Single-center Observational Study in Children and Adolescents With Cancer.

STUDY AIMS Based on prospectively collected information on ear temperatures, ANC values, emergency calls and consultations for fever, and on hospitalizations for FN in children and adolescents with cancer

• to describe the frequency of episodes of FN, and of other clinically relevant FN-related measures
• to compare these frequencies and measures in reality vs. applying Bernese standard limits for defining fever (ear temperature ≥39.0°C)
• to compare these frequencies and measures applying the Bernese standard limit of ≥39.0°C (LimitStandard) vs. a range of hypothetically lower limits defining fever (LimitLow)
• to determine if it would be useful to perform an interventional study on the question of different fever limits, powered to study both efficacy (frequency of FN) and safety (AE in delayed FN diagnosis)
• to use the platform of this prospective study to explore if the serum level of cortisol is associated with adverse events in FN

HYPOTHESIS In children and adolescents with cancer, hypothetically modifying the definitions of fever from ear temperature 39.0°C to lower limits would

• increase the rate of FN episodes diagnosed during chemotherapy (primary endpoint).
• increase the rate of other clinically important FN-related measures related to chemotherapy exposure time (secondary endpoints 1,2,3) and outcome/treatment-related measures during treatment of FN episodes diagnosed in reality (secondary endpoints 4,5,6).
• not relevantly decrease the proportion of FN with AE (secondary endpoint 7).

Inclusion Criteria:

• >1 year and ≤17 years at time of recruitment
• Chemotherapy treatment because of any malignancy for at least 2 months at time of recruitment
• Written informed consent from patients and/or parents for the study

Exclusion Criteria:

• Infants ≤1 year old (reason: differences in standard fever limit and method to measure temperature)
• Denied written informed consent from patients and/or parents for the study