Prediction of neutropenia

Newer treatment strategies for the management of febrile neutropenic patients are being developed. These include: (a) hospital based oral therapy; (b) early discharge after initial stabilization in-hospital, and (c) out-patient therapy. All strategies are likely to be more successful in patients with short-lived neutropenia (< or = 7 days) than in those with more prolonged neutropenia. Although risk-prediction rules and clinical criteria can help clinicians identify 'low-risk' neutropenic patients, the overall ability of clinicians to accurately predict the subsequent duration of neutropenia once a neutropenic patient becomes febrile needs to be improved upon considerably. One attempt to do so is the survey being conducted by the Infection Study Section of the Multinational Association of Supportive Care in Cancer (MASCC). Development of an accurate rule for the prediction of neutropenia will enable more appropriate, risk-based therapy to be administered to febrile neutropenic patients, and will represent a significant advance in the management of such patients.