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Clinical Index of Stable Febrile Neutropenia

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1. Prognostic accuracy of the Multinational Association of Supportive Care of Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for identifying low-risk adult patients with febrile neutropenia

Prognostic accuracy of the Multinational Association of Supportive Care of Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for identifying low-risk adult patients with febrile neutropenia Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete (...) . Not an original full research paper (e.g. review, editorial) 2. Not an in vivo animal study 3. No metastases/ only primary tumor 4. No control group 5. Combination therapy or contamination 6. Not about analgesics used in the clinic Full text-screening: As above, with the addition of: 7. No relevant outcome measure reported ">Prioritise the exclusion criteria Example: Two reviewers will independently extract data from each article. We first try to extract numerical data from tables, text or figures

2019 PROSPERO

2. Validation of the Clinical Index of Stable Febrile Neutropenia (CISNE) model in febrile neutropenia patients visiting the emergency department. Can it guide emergency physicians to a reasonable decision on outpatient vs. inpatient treatment? (Full text)

Validation of the Clinical Index of Stable Febrile Neutropenia (CISNE) model in febrile neutropenia patients visiting the emergency department. Can it guide emergency physicians to a reasonable decision on outpatient vs. inpatient treatment? Advances in oncology have enabled physicians to treat low-risk febrile neutropenia (FN) in outpatient settings. This study was aimed to explore the usefulness of the CISNE model and identify better triage in the emergency setting. This is a retrospective (...) cohort study on 400 adult FN patients presenting to the Emergency Department of National Cancer Center, Korea from January 2010 to December 2016. All had been treated with cytotoxic chemotherapy for solid tumors in the previous 30 days. The primary outcome was the frequency of any serious complications during the duration of illness. Apparently stable patients numbered 299 (74.8%) of 400, and the remainder comprised clinically unstable patients. The stable patients fell into three cohorts according

2018 PLoS ONE PubMed

3. Prediction of Serious Complications in Patients With Seemingly Stable Febrile Neutropenia: Validation of the Clinical Index of Stable Febrile Neutropenia in a Prospective Cohort of Patients From the FINITE Study (PubMed)

Prediction of Serious Complications in Patients With Seemingly Stable Febrile Neutropenia: Validation of the Clinical Index of Stable Febrile Neutropenia in a Prospective Cohort of Patients From the FINITE Study To validate a prognostic score predicting major complications in patients with solid tumors and seemingly stable episodes of febrile neutropenia (FN). The definition of clinical stability implies the absence of organ dysfunction, abnormalities in vital signs, and major infections.We (...) developed the Clinical Index of Stable Febrile Neutropenia (CISNE), with six explanatory variables associated with serious complications: Eastern Cooperative Oncology Group performance status ≥ 2 (2 points), chronic obstructive pulmonary disease (1 point), chronic cardiovascular disease (1 point), mucositis of grade ≥ 2 (National Cancer Institute Common Toxicity Criteria; 1 point), monocytes < 200 per μL (1 point), and stress-induced hyperglycemia (2 points). We integrated these factors into a score

2015 EvidenceUpdates

4. Clinical Index of Stable Febrile Neutropenia

Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Aka: Clinical Index of Stable Febrile Neutropenia , CISNE Score II. Indications Assess risk in III. Contraindications Age <18 years old Hospitalization for other reason (e.g. PE, arrhythmia) Acute organ failure or decompensation of chronic insufficiency (e.g. , , CHF) or with systolic <90 mmHg Severe infection IV. Criteria Score 2: ( ) >2 Score 2: Stress induced Score 1: Score 1: Chronic cardiovascular

2018 FP Notebook

5. Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study. (PubMed)

Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study. To validate a prognostic score predicting major complications in patients with solid tumors and seemingly stable episodes of febrile neutropenia (FN). The definition of clinical stability implies the absence of organ dysfunction, abnormalities in vital signs, and major infections.We (...) developed the Clinical Index of Stable Febrile Neutropenia (CISNE), with six explanatory variables associated with serious complications: Eastern Cooperative Oncology Group performance status ≥ 2 (2 points), chronic obstructive pulmonary disease (1 point), chronic cardiovascular disease (1 point), mucositis of grade ≥ 2 (National Cancer Institute Common Toxicity Criteria; 1 point), monocytes < 200 per μL (1 point), and stress-induced hyperglycemia (2 points). We integrated these factors into a score

2015 Journal of Clinical Oncology

6. Clinical Index of Stable Febrile Neutropenia

Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer (...) Administration 4 Clinical Index of Stable Febrile Neutropenia Clinical Index of Stable Febrile Neutropenia Aka: Clinical Index of Stable Febrile Neutropenia , CISNE Score II. Indications Assess risk in III. Contraindications Age <18 years old Hospitalization for other reason (e.g. PE, arrhythmia) Acute organ failure or decompensation of chronic insufficiency (e.g. , , CHF) or with systolic <90 mmHg Severe infection IV. Criteria Score 2: ( ) >2 Score 2: Stress induced Score 1: Score 1: Chronic cardiovascular

2017 FP Notebook

7. A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia. (Full text)

A nomogram for predicting complications in patients with solid tumours and seemingly stable febrile neutropenia. We sought to develop and externally validate a nomogram and web-based calculator to individually predict the development of serious complications in seemingly stable adult patients with solid tumours and episodes of febrile neutropenia (FN).The data from the FINITE study (n=1133) and University of Salamanca Hospital (USH) FN registry (n=296) were used to develop and validate (...) this tool. The main eligibility criterion was the presence of apparent clinical stability, defined as events without acute organ dysfunction, abnormal vital signs, or major infections. Discriminatory ability was measured as the concordance index and stratification into risk groups.The rate of infection-related complications in the FINITE and USH series was 13.4% and 18.6%, respectively. The nomogram used the following covariates: Eastern Cooperative Group (ECOG) Performance Status ⩾2, chronic

2016 British Journal of Cancer PubMed

8. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

identification of candidate patients for outpatient treatment. (¶)See Recommendation 3.1 regarding evaluation of patients for hospital admission. CISNE, Clinical Index of Stable Febrile Neutropenia; MASCC, Multinational Association for Supportive Care in Cancer. Guideline Questions What is the recommended initial diagnostic approach for patients with fever who are seeking emergency medical care within 6 weeks of receiving chemotherapy? Which patients with FN are at low risk of medical complications (...) /cephalosporins should be treated as inpatients with a carbapenem-based regimen that likely requires multiple doses per day. Patients colonized with or suspected of having MRSA, VRE, or Stenotrophomonas maltophilia infection should be considered as candidates for inpatient management. Patients undergoing HSCT or induction therapy for acute leukemia are unlikely to be appropriate candidates for outpatient therapy. Recommendation 2.2. The Clinical Index of Stable Febrile Neutropenia (CISNE; ) may be used

2018 American Society of Clinical Oncology Guidelines

9. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

identification of candidate patients for outpatient treatment. (¶)See Recommendation 3.1 regarding evaluation of patients for hospital admission. CISNE, Clinical Index of Stable Febrile Neutropenia; MASCC, Multinational Association for Supportive Care in Cancer. Guideline Questions What is the recommended initial diagnostic approach for patients with fever who are seeking emergency medical care within 6 weeks of receiving chemotherapy? Which patients with FN are at low risk of medical complications (...) /cephalosporins should be treated as inpatients with a carbapenem-based regimen that likely requires multiple doses per day. Patients colonized with or suspected of having MRSA, VRE, or Stenotrophomonas maltophilia infection should be considered as candidates for inpatient management. Patients undergoing HSCT or induction therapy for acute leukemia are unlikely to be appropriate candidates for outpatient therapy. Recommendation 2.2. The Clinical Index of Stable Febrile Neutropenia (CISNE; ) may be used

2018 Infectious Diseases Society of America

10. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update.

in Children and Young People with Febrile Neutropenia This update review was conducted in accordance with "Systematic reviews: Centre for Reviews and Dissemination's (CRD's) guidance for undertaking reviews in health care" and registered on the PROSPERO Registry of systematic reviews: CRD42011001685. It sought studies which aimed to derive or validate a clinical decision rules (CDR) in children or young people (aged 0–18 years) presenting with febrile neutropenia (FN). Both prospective and retrospective (...) reviewers. The search was updated to include articles indexed as of 29 February 2016. Systematic Review and Meta-analysis of the Value of Clinical Features to Exclude Radiographic Pneumonia in Febrile Neutropenic Episodes in Children and Young People The review was conducted in accordance with "Systematic reviews: CRD's guidance for undertaking reviews in health care." In keeping with recent recommendations, the protocol was registered with the HTA Registry of systematic reviews, CRD32009100453. Search

2017 National Guideline Clearinghouse (partial archive)

11. Management of Febrile Neutropaenia

with neutropenia during cancer chemotherapy. N Engl J Med 1999; 341: 305–311. 17. Innes H, Lim SL, Hall A et al. Management of febrile neutropenia in solid tumours and lymphomas using the Multinational Association for Supportive Care in Cancer (MASCC) risk index: feasibility and safety in routine clinical practice. Support Care Cancer 2008; 16: 485–491. 18. Kern WV, Marchetti O, Drgona L et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer: a double-blind, multicenter trial comparing (...) : an evidence-based clinical practice guideline. J Clin Oncol 2006; 24: 3187–3205. 10. Sung L, Nathan PC, Alibhai SM et al. Meta-analysis: effect of prophylactic hematopoietic colony-stimulating factors on mortality and outcomes of infections. Ann Intern Med 2007; 147: 400–411. 11. Wang L, Baser O, Kutikova L et al. The impact of primary prophylaxis with granulocyte colony-stimulating factors on febrile neutropenia during chemotherapy: a systematic review and meta-analysis of randomized controlled trials

2017 European Society for Medical Oncology

12. Short vs Prolonged Antibiotic Treatment for Hospitalized Hemato-oncology Patients With Febrile Neutropenia

information Study Type : Interventional (Clinical Trial) Estimated Enrollment : 110 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment Official Title: Prospective Unblinded Randomized Trial to Examine Short vs Prolonged Antibiotic Treatment for Hospitalized Hemato-oncology Patients With Febrile Neutropenia Study Start Date : June 2015 Estimated Primary Completion Date : June 2017 Estimated Study Completion Date : July 2017 (...) Short vs Prolonged Antibiotic Treatment for Hospitalized Hemato-oncology Patients With Febrile Neutropenia Short vs Prolonged Antibiotic Treatment for Hospitalized Hemato-oncology Patients With Febrile Neutropenia - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2015 Clinical Trials

13. International Guideline for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation

: Empirical antifungal therapy in neutropaenic cancer patients with persistent fever. EJC 5:32-42, 2007 (suppl) 6. National Comprehensive Cancer Network: NCCN Guidelines TM for Supportive Care: Prevention and Treatment of Cancer-Related Infections (Version 2.2011), Fort Washington, PA: National Comprehensive Cancer Network, 2011 (http://www.nccn.org/professionals/physician_gls/f_guidelines.asp) 7. de Naurois J, Novitzky-Basso I, Gill MJ, et al: Management of febrile neutropenia: ESMO Clinical Practice (...) chest radiography in children with cancer hospitalized for fever and neutropenia. Cancer 68:940-3, 1991 55. Phillips R, Wade R, Riley R, et al: Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people. J Paediatr Child Health, 2011 56. Furno P, Bucaneve G, Del Favero A: Monotherapy or aminoglycoside-containing combinations for empirical antibiotic treatment of febrile neutropenic patients

2012 SickKids Supportive Care Guidelines

14. Application of the MASCC and CISNE Risk-Stratification Scores to Identify Low-Risk Febrile Neutropenic Patients in the Emergency Department. (PubMed)

Index of Stable Febrile Neutropenia (CISNE) scores for patients with chemotherapy-induced febrile neutropenia and presenting to the ED.We conducted a retrospective cohort study to evaluate all patients with febrile neutropenia (temperature ≥38°C [100.4°F], absolute neutrophil count <1,000 cells/μL) who presented to 2 academic EDs from June 2012 through January 2015. MASCC and CISNE scores were calculated for all subjects, and each visit was evaluated for several outcome variables, including (...) inpatient length of stay, upgrade in level of care, clinical deterioration, positive blood culture results, and death. Descriptive statistics are reported and continuous variables were analyzed with Wilcoxon rank sum.During our study period, 230 patients presented with chemotherapy-induced febrile neutropenia. The CISNE score identified 53 (23%) of these patients as low risk and was highly specific in the identification of a low-risk cohort for all outcome variables (98.3% specific, 95% confidence

2016 Annals of Emergency Medicine

15. Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline

Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline ASCO special article Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline Joseph Mikhael,MD 1,2 ; No?sat Ismaila,MD 3 ; Matthew C. Cheung, MD, SM 4 ; Caitlin Costello,MD 5 ; Madhav V. Dhodapkar,MD 6 ; Shaji Kumar,MD 7 ; Martha Lacy,MD 7 ; Brea Lipe,MD 8 ; Richard F. Little,MD 9 ; Anna Nikonova, MD, CM 10 ; James Omel,MD 11 ; NamrataPeswani,MD 12 ;AncaPrica,MD 13 ;NoopurRaje,MD 14 ;RahulSeth,DO (...) are transplantation eligible and those who are ineligible and for patients with relapsed or refractory disease. Additional information is available at www.asco.org/hematologic-malignancies-guidelines. J Clin Oncol 37. © 2019 by American Society of Clinical Oncology INTRODUCTION The purpose of this guideline is to provide evidence- based recommendations for the treatment of newly diagnosed and relapsed multiple myeloma. The treatment of multiple myeloma has changed signi?- cantly in the last 5 years. Since 2015

2019 Cancer Care Ontario

16. Clinical Practice Guidelines for The Management of Candidiasis (Full text)

are not critically ill and have had no prior azole exposure (weak recommendation; low-quality evidence) . 17. Fluconazole, 400 mg (6 mg/kg) daily, can be used for step-down therapy during persistent neutropenia in clinically stable patients who have susceptible isolates and documented bloodstream clearance (weak recommendation; low-quality evidence) . 18. Voriconazole, 400 mg (6 mg/kg) twice daily for 2 doses, then 200–300 mg (3–4 mg/kg) twice daily, can be used in situations in which additional mold coverage (...) is desired (weak recommendation; low-quality evidence). Voriconazole can also be used as step-down therapy during neutropenia in clinically stable patients who have had documented bloodstream clearance and isolates that are susceptible to voriconazole (weak recommendation; low-quality evidence) . 19. For infections due to C. krusei , an echinocandin, lipid formulation AmB, or voriconazole is recommended (strong recommendation; low-quality evidence) . 20. Recommended minimum duration of therapy

2016 Infectious Diseases Society of America PubMed

17. Neutropenia (Overview)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) in neutropenic patients: effect of augmented gram-positive activity on infectious morbidity. National Cancer Institute of Canada Clinical Trials Group. Ann Intern Med . 1996 Aug 1. 125(3):183-90. . Freifeld A, Marchigiani D, Walsh T, Chanock S, Lewis L, Hiemenz J, et al. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy. N Engl J Med . 1999 Jul 29. 341(5):305-11. . [Guideline] Taplitz RA, Kennedy EB, Bow EJ

2014 eMedicine.com

18. Neutropenia (Diagnosis)

with solid tumors who have undergone mild- to moderate-intensity chemotherapy, who appear to be clinically stable, and who are in close proximity to an appropriate medical facility that can provide 24-hour access, the Clinical Index of Stable Febrile Neutropenia (CISNE) may be used as an additional tool to determine the risk of major complications. [ ] Splenectomy In individuals with neutropenia and Felty syndrome who have recurrent, life-threatening bacterial infections, splenectomy is the treatment (...) in neutropenic patients: effect of augmented gram-positive activity on infectious morbidity. National Cancer Institute of Canada Clinical Trials Group. Ann Intern Med . 1996 Aug 1. 125(3):183-90. . Freifeld A, Marchigiani D, Walsh T, Chanock S, Lewis L, Hiemenz J, et al. A double-blind comparison of empirical oral and intravenous antibiotic therapy for low-risk febrile patients with neutropenia during cancer chemotherapy. N Engl J Med . 1999 Jul 29. 341(5):305-11. . [Guideline] Taplitz RA, Kennedy EB, Bow EJ

2014 eMedicine.com

19. Diagnosis, Risk Stratification, and Management of Pulmonary Hypertension of Sickle Cell Disease: An Official ATS Clinical Practice Guideline

. The TRV should be measured by Doppler echocardiography, using the same conditionsasthestudiesdescribedpreviously, because the TRV varies according to the clinicalstatusofthepatient(i.e.,theTRVmay beacutelyandtransientlyincreasedduringan acute illness such as a vaso-occlusive crisis [VOC] or acute chest syndrome [ACS]) (29). Therefore, Doppler echocardiography should be performed when the patient is in a stable clinical state, de?ned as more than 4 weeks after hospitalization for ACS and more than 2 (...) are clinically stable. Patients with an mPAP between 20 and 25 mm Hg need further study as they may be at increased mortality risk. Note: PAH therapy is to be considered on the basis of a weak recommendation and very low-quality evidence. AMERICAN THORACIC SOCIETY DOCUMENTS American Thoracic Society Documents 733 that prolonged therapy may be necessary to achieve a clinical bene?t (39, 40). Patients who received HU during the MSH trial also had improvement in some measures of quality of life (i.e., social

2014 American Thoracic Society

20. Metastatic Non-Small-Cell Lung Cancer: ESMO Clinical Practice Guidelines

comparing monthly car- boplatin plus weekly paclitaxel versus single-agent vinorelbine or gemcitabine in patients aged 70–89 years with PS 0–2 has reportedasurvivaladvantageforcombinationtherapy[35]. Bene?t was observed across all subgroups, but increased tox- icity (notably febrile neutropenia and sepsis-related deaths) was observed. Platinum-based chemotherapy is the preferred option for elderly patients with PS 0-1—as well as selected PS2—and adequate organ function, while a single-agent approach (...) Metastatic Non-Small-Cell Lung Cancer: ESMO Clinical Practice Guidelines Metastaticnon-small-celllungcancer(NSCLC):ESMO ClinicalPracticeGuidelinesfordiagnosis,treatment andfollow-up † M.Reck 1,2 ,S.Popat 3,4 ,N.Reinmuth 1,2 ,D.DeRuysscher 5 ,K.M.Kerr 6 ,S.Peters 7 & onbehalfof theESMOGuidelinesWorkingGroup * 1 DepartmentofThoracicOncology,LungenClinic,Grosshansdorf; 2 MemberoftheGermanCenterforLungResearch(DZL),Germany; 3 RoyalMarsdenHospitalNHS FoundationTrust,London; 4

2014 European Society for Medical Oncology

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