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Management of Febrile Neutropenia due to Chemotherapy in Latin America: An Evidence-Based Study and Expert Consensus

Author(s): Greys Jimbo, María Cabezas*, Erika Pavon, M. Fernandez and Nicole Aguirre
Department of Internal Medicine, Hospital SOLCA Quito, Quito 170138, 1Health and Research Services, Quito 170515, 2Department of Clinical Oncology, Universidad Central del Ecuador, Quito 170129, 3Department of Medicine, School of Medicine, Pontificia Universidad Católica del Ecuador, Quito 170143, Ecuador

Correspondence Address:
María Cabezas, Department of Medicine, School of Medicine, Pontificia Universidad Católica del Ecuador, Quito 170143, Ecuador, E-mail:

Febrile neutropenia is a common and serious complication of cancer chemotherapy. This pathology is characterized by a diminished absolute neutrophil count and elevated temperature. Despite recent therapeutic advances, febrile neutropenia is still a major cause of morbidity and mortality among cancer patients in Latin America and worldwide. This onco-hematological emergency condition also involves a high risk of complications and healthcare costs. The objective of this protocol was to develop a reference tool for the evaluation and management of febrile neutropenia in a fourth-level cancer hospital in Ecuador and provide a guideline for a timely and adequate care of cancer patients. The present project implemented an extensive bibliographic search of the last 15 y which included guidelines and scientific publications. The appraisal of guidelines for research and evaluation II and grading of recommendations, assessment, development and evaluation instruments were used to develop an expert consensus and evaluate the level of evidence of each recommendation. This document compiles updated information available on the definition, risk factors, evaluation methods, treatment and special situations in cancer patients with febrile neutropenia. Moreover, the following report allows to classify patients according to their risk level and to provide the best pharmacological strategy with their respective doses and routes of administration. Cytotoxic chemotherapy often induces febrile neutropenia and may lead to serious complications including mortality. Therefore, information available on febrile neutropenia was compiled to create a comprehensive protocol of the complication.

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