Febrile neutropenia

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National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prevention and treatment of cancer-related infections [internet publication].Full text

Klastersky J, de Naurois J, Rolston K, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2016 Sep;27(5 suppl):v111-8.Full text  Abstract

Smith TJ, Bohlke K, Lyman GH, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2015 Oct 1;33(28):3199-212. Abstract

Taplitz RA, Kennedy EB, Bow EJ, et al. Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update. J Clin Oncol. 2018 Feb 20;36(14):1443-53.Full text  Abstract

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3. Freifeld AG, Bow EJ, Sepkowitz KA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2011 Feb 15;52(4):e56-93.Full text  Abstract

4. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: prevention and treatment of cancer-related infections [internet publication].Full text

5. Talcott JA, Siegel RD, Finberg R, et al. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. J Clin Oncol. 1992 Feb;10(2):316-22. Abstract

6. Klastersky J, Paesmans M, Rubenstein EB, et al. The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000 Aug;18(16):3038-51. Abstract

7. Carmona-Bayonas A, Jiménez-Fonseca P, Virizuela Echaburu J, et al. 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. J Clin Oncol. 2015 Feb 10;33(5):465-71. Abstract

8. Tai E, Guy GP, Dunbar A, et al. Cost of cancer-related neutropenia or fever hospitalizations, United States, 2012. J Oncol Pract. 2017 Jun;13(6):e552-61.Full text  Abstract

9. Weycker D, Li X, Edelsberg J, et al. Risk and consequences of chemotherapy-induced febrile neutropenia in patients with metastatic solid tumors. J Oncol Pract. 2015 Jan;11(1):47-54.Full text  Abstract

10. Weycker D, Barron R, Kartashov A, et al. Incidence, treatment, and consequences of chemotherapy-induced febrile neutropenia in the inpatient and outpatient settings. J Oncol Pharm Pract. 2014 Jun;20(3):190-8. Abstract

11. Crawford J, Dale DC, Kuderer NM, et al. Risk and timing of neutropenic events in adult cancer patients receiving chemotherapy: the results of a prospective nationwide study of oncology practice. J Natl Compr Canc Netw. 2008 Feb;6(2):109-18. Abstract

12. Lyman GH, Morrison VA, Dale DC, et al. Risk of febrile neutropenia among patients with intermediate-grade non-Hodgkin's lymphoma receiving CHOP chemotherapy. Leuk Lymphoma. 2003 Dec;44(12):2069-76. Abstract

13. Pettengell R, Bosly A, Szucs TD, et al. Multivariate analysis of febrile neutropenia occurrence in patients with non-Hodgkin lymphoma: data from the INC-EU Prospective Observational European Neutropenia Study. Br J Haematol. 2009 Mar;144(5):677-85.Full text  Abstract

14. Chao C, Page JH, Yang SJ, et al. History of chronic comorbidity and risk of chemotherapy-induced febrile neutropenia in cancer patients not receiving G-CSF prophylaxis. Ann Oncol. 2014 Sep;25(9):1821-9.Full text  Abstract

15. Leon Rapoport B, Garcia-Morillo M, Font C, et al. A prospective, real-world, multinational study of febrile neutropenia (FN) occurrence in oncology patients receiving chemotherapy with intermediate risk of FN: a MASCC Neutropenia, Infection, and Myelosuppression Study Group initiative. Support Care Cancer. 2023 Oct 13;31(12):628.Full text  Abstract

16. Caggiano V, Weiss RV, Rickert TS, et al. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005 May 1;103(9):1916-24.Full text  Abstract

17. Kuderer NM, Dale DC, Crawford J, et al. Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer. 2006 May 15;106(10):2258-66.Full text  Abstract

18. Zimmer AJ, Stohs E, Meza J, et al. Bloodstream infections in hematologic malignancy patients with fever and neutropenia: are empirical antibiotic therapies in the United States still effective? Open Forum Infect Dis. 2022 Jul;9(7):ofac240.Full text  Abstract

19. Hakim H, Flynn PM, Knapp KM, et al. Etiology and clinical course of febrile neutropenia in children with cancer. J Pediatr Hematol Oncol. 2009 Sep;31(9):623-9.Full text  Abstract

20. Klastersky J, de Naurois J, Rolston K, et al. Management of febrile neutropaenia: ESMO Clinical Practice Guidelines. Ann Oncol. 2016 Sep;27(5 suppl):v111-8.Full text  Abstract

21. Klastersky J, Ameye L, Maertens J, et al. Bacteraemia in febrile neutropenic cancer patients. Int J Antimicrob Agents. 2007 Nov;30 Suppl 1:S51-9.Full text  Abstract

22. Feld R. Bloodstream infections in cancer patients with febrile neutropenia. Int J Antimicrob Agents. 2008 Nov;32 Suppl 1:S30-3.Full text  Abstract

23. El Assaad N, Azzi A, Haddad F, et al. Febrile neutropenia in the Middle East and North Africa Region: trends, management, and outcomes (2000-2024) - a systematic review. IJID Reg. 2025 Sep;16:100682.Full text  Abstract

24. Chumbita M, Peyrony O, Teijón-Lumbreras C, et al. Current microbiological testing approaches and documented infections at febrile neutropenia onset in patients with hematologic malignancies. Int J Infect Dis. 2024 Oct;147:107183.Full text  Abstract

25. Cooksley T, Holland M. The febrile patient with neutropenia. Acute Med. 2012;11(4):246-50. Abstract

26. Sipsas NV, Bodey GP, Kontoyiannis DP. Perspectives for the management of febrile neutropenic patients with cancer in the 21st century. Cancer. 2005 Mar 15;103(6):1103-13.Full text  Abstract

27. Murono K, Hirano Y, Koyano S, et al. Molecular comparison of bacterial isolates from blood with strains colonizing pharynx and intestine in immunocompromised patients with sepsis. J Med Microbiol. 2003 Jun;52(pt 6):527-30. Abstract

28. Erdem H, Kocoglu E, Ankarali H, et al. Prospective analysis of febrile neutropenia patients with bacteraemia: the results of an international ID-IRI study. Int J Antimicrob Agents. 2023 Sep;62(3):106919. Abstract

29. Gajdács M, Urbán E. Relevance of anaerobic bacteremia in adult patients: a never-ending story? Eur J Microbiol Immunol (Bp). 2020 Jun 5;10(2):64-75.Full text  Abstract

30. Obrová K, Grumaz S, Remely M, et al. Presence of viremia during febrile neutropenic episodes in patients undergoing chemotherapy for malignant neoplasms. Am J Hematol. 2021 Jun 1;96(6):719-26.Full text  Abstract

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32. Robenshtok E, Gafter-Gvili A, Goldberg E, et al. Antifungal prophylaxis in cancer patients after chemotherapy or hematopoietic stem-cell transplantation: systematic review and meta-analysis. J Clin Oncol. 2007 Dec 1;25(34):5471-89. Abstract

33. Zimmer AJ, Freifeld AG. Optimal management of neutropenic fever in patients with cancer. J Oncol Pract. 2019 Jan;15(1):19-24.Full text  Abstract

34. van der Velden WJ, Herbers AH, Netea MG, et al. Mucosal barrier injury, fever and infection in neutropenic patients with cancer: introducing the paradigm febrile mucositis. Br J Haematol. 2014 Nov;167(4):441-52.Full text  Abstract

35. Lyman GH, Abella E, Pettengell R. Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: a systematic review. Crit Rev Oncol Hematol. 2014 Jun;90(3):190-9. Abstract

36. Do T, Medhekar R, Bhat R, et al. The risk of febrile neutropenia and need for G-CSF primary prophylaxis with the docetaxel and cyclophosphamide regimen in early-stage breast cancer patients: a meta-analysis. Breast Cancer Res Treat. 2015 Oct;153(3):591-7. Abstract

37. Choi YW, Jeong SH, Ahn MS, et al. Patterns of neutropenia and risk factors for febrile neutropenia of diffuse large B-cell lymphoma patients treated with rituximab-CHOP. J Korean Med Sci. 2014 Nov;29(11):1493-500.Full text  Abstract

38. Dimitrijević J, Čalamać M, Đurmez O, et al. Serum albumin as a prognostic biomarker for febrile neutropenia outcome and complications: a prospective observational trial. Clin Med Insights Oncol. 2024;18:11795549241281330.Full text  Abstract

39. Lyman GH, Kuderer NM, Crawford J, et al. Predicting individual risk of neutropenic complications in patients receiving cancer chemotherapy. Cancer. 2011 May 1;117(9):1917-27.Full text  Abstract

40. Zhu Y, Guo D, Kong X, et al. A risk-prediction nomogram for neutropenia or febrile neutropenia after etoposide-based chemotherapy in cancer patients: a retrospective cohort study. Pharmacology. 2022;107(1-2):69-80. Abstract

41. Aagaard T, Roen A, Reekie J, et al. Development and validation of a risk score for febrile neutropenia after chemotherapy in patients with cancer: the FENCE score. JNCI Cancer Spectr. 2018 Oct;2(4):pky053.Full text  Abstract

42. Silber JH, Fridman M, DiPaola RS, et al. First-cycle blood counts and subsequent neutropenia, dose reduction, or delay in early-stage breast cancer therapy. J Clin Oncol. 1998 Jul;16(7):2392-400. Abstract

43. Rivera E, Haim Erder M, Fridman M, et al. First-cycle absolute neutrophil count can be used to improve chemotherapy-dose delivery and reduce the risk of febrile neutropenia in patients receiving adjuvant therapy: a validation study. Breast Cancer Res. 2003;5(5):R114-20.Full text  Abstract

44. Taplitz RA, Kennedy EB, Bow EJ, et al. Antimicrobial prophylaxis for adult patients with cancer-related immunosuppression: ASCO and IDSA clinical practice guideline update. J Clin Oncol. 2018 Oct;36(30):3043-54.Full text  Abstract

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47. Kubeček O, Paterová P, Novosadová M. Risk Factors for infections, antibiotic therapy, and its impact on cancer therapy outcomes for patients with solid tumors. Life (Basel). 2021 Dec 11;11(12):1387.Full text  Abstract

48. Talcott JA, Finberg R, Mayer RJ, et al. The medical course of cancer patients with fever and neutropenia. Clinical identification of a low-risk subgroup at presentation. Arch Intern Med. 1988 Dec;148(12):2561-8. Abstract

49. Lyman GH, Dale DC, Friedberg J, et al. Incidence and predictors of low chemotherapy dose-intensity in aggressive non-Hodgkin's lymphoma: a nationwide study. J Clin Oncol. 2004 Nov 1;22(21):4302-11.Full text  Abstract

50. Thursky KA, Worth LJ, Seymour JF, et al. Spectrum of infection, risk and recommendations for prophylaxis and screening among patients with lymphoproliferative disorders treated with alemtuzumab*. Br J Haematol. 2006 Jan;132(1):3-12.Full text  Abstract

51. Martin SI, Marty FM, Fiumara K, et al. Infectious complications associated with alemtuzumab use for lymphoproliferative disorders. Clin Infect Dis. 2006 Jul 1;43(1):16-24.Full text  Abstract

52. Family L, Li Y, Chen LH, et al. A study of novel febrile neutropenia risk factors related to bone marrow or immune suppression, barrier function, and bacterial flora. J Natl Compr Canc Netw. 2018 Oct;16(10):1201-8.Full text  Abstract

53. 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. Support Care Cancer. 2015 Nov;23(11):3131-40.Full text  Abstract

54. Renner P, Milazzo S, Liu JP, et al. Primary prophylactic colony-stimulating factors for the prevention of chemotherapy-induced febrile neutropenia in breast cancer patients. Cochrane Database Syst Rev. 2012 Oct 17;(10):CD007913.Full text  Abstract

55. Kuderer NMD. Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol. 2007 Jul 20;25(21):3158-67. Abstract

56. Cooper KL, Madan J, Whyte S, et al. Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy: systematic review and meta-analysis. BMC Cancer. 2011 Sep 23;11:404.Full text  Abstract

57. Smith TJ, Bohlke K, Lyman GH, et al. Recommendations for the use of WBC growth factors: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2015 Oct 1;33(28):3199-212. Abstract

58. Aapro MS, Bohlius J, Cameron DA, et al; European Organisation for Research and Treatment of Cancer. 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer. 2011 Jan;47(1):8-32. Abstract

59. Bond TC, Szabo E, Gabriel S, et al. Meta-analysis and indirect treatment comparison of lipegfilgrastim with pegfilgrastim and filgrastim for the reduction of chemotherapy-induced neutropenia-related events. J Oncol Pharm Pract. 2018 Sep;24(6):412-23.Full text  Abstract

60. Pfeil AM, Allcott K, Pettengell R, et al. Efficacy, effectiveness and safety of long-acting granulocyte colony-stimulating factors for prophylaxis of chemotherapy-induced neutropenia in patients with cancer: a systematic review. Support Care Cancer. 2015 Feb;23(2):525-45. Abstract

61. Schwartzberg LS, Bhat G, Peguero J, et al. Eflapegrastim, a long-acting granulocyte-colony stimulating factor for the management of chemotherapy-induced neutropenia: results of a phase III trial. Oncologist. 2020 Aug;25(8):e1233-41.Full text  Abstract

62. Cobb PW, Moon YW, Mezei K, et al. A comparison of eflapegrastim to pegfilgrastim in the management of chemotherapy-induced neutropenia in patients with early-stage breast cancer undergoing cytotoxic chemotherapy (RECOVER): a phase 3 study. Cancer Med. 2020 Sep;9(17):6234-43.Full text  Abstract

63. Skoetz N, Bohlius J, Engert A, et al. Prophylactic antibiotics or G(M)-CSF for the prevention of infections and improvement of survival in cancer patients receiving myelotoxic chemotherapy. Cochrane Database Syst Rev. 2015 Dec 21;(12):CD007107.Full text  Abstract

64. Wingard JR, Eldjerou L, Leather H. Use of antibacterial prophylaxis in patients with chemotherapy-induced neutropenia. Curr Opin Hematol. 2012 Jan;19(1):21-6. Abstract

65. Bow EJ. Fluoroquinolones, antimicrobial resistance and neutropenic cancer patients. Curr Opin Infect Dis. 2011 Dec;24(6):545-53. Abstract

66. Mikulska M, Averbuch D, Tissot F, et al. Fluoroquinolone prophylaxis in haematological cancer patients with neutropenia: ECIL critical appraisal of previous guidelines. J Infect. 2018 Jan;76(1):20-37. Abstract

67. Singh N, Thursky K, Maron G, et al. Fluoroquinolone prophylaxis in patients with neutropenia at high risk of serious infections: Exploring pros and cons. Transpl Infect Dis. 2023 Nov;25 Suppl 1:e14152. Abstract

68. Rusu A, Munteanu AC, Arbănași EM, et al. Overview of side-effects of antibacterial fluoroquinolones: new drugs versus old drugs, a step forward in the safety profile? Pharmaceutics. 2023 Mar 1;15(3):804.Full text  Abstract

69. Groll AH, Pana D, Lanternier F, et al. 8th European Conference on Infections in Leukaemia: 2020 guidelines for the diagnosis, prevention, and treatment of invasive fungal diseases in paediatric patients with cancer or post-haematopoietic cell transplantation. Lancet Oncol. 2021 Jun;22(6):e254-69. Abstract

70. Papanicolaou GA, Chen M, He N, et al. Incidence and impact of fungal infections in post-transplantation cyclophosphamide-based graft-versus-host disease prophylaxis and haploidentical hematopoietic cell transplantation: a center for International Blood and Marrow Transplant Research Analysis. Transplant Cell Ther. 2024 Jan;30(1):114.e1-16.Full text  Abstract

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72. Strojnik K, Mahkovic-Hergouth K, Novakovic BJ, et al. Outcome of severe infections in afebrile neutropenic cancer patients. Radiol Oncol. 2016 Feb 10;50(4):442-8.Full text  Abstract

73. Tran M, Palmer S, Moore DT, et al. Utility of urine cultures during febrile neutropenia workup in hematopoietic stem cell transplantation recipients without urinary symptoms. Open Forum Infect Dis. 2023 May;10(5):ofad236.Full text  Abstract

74. Grigg SE, Date P, Loh Z, et al. Urine cultures at the onset of febrile neutropenia rarely impact antibiotic management in asymptomatic adult cancer patients. Support Care Cancer. 2019 Apr;27(4):1223-7. Abstract

75. Taplitz RA, Kennedy EB, Bow EJ, et al. Outpatient management of fever and neutropenia in adults treated for malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America clinical practice guideline update. J Clin Oncol. 2018 Feb 20;36(14):1443-53.Full text  Abstract

76. Rosenblum J, Lin J, Kim M, et al. Repeating blood cultures in neutropenic children with persistent fevers when the initial blood culture is negative. Pediatr Blood Cancer. 2013 Jun;60(6):923-7. Abstract

77. Laracy JC, Chan JL, Kodama R, et al. Improving urinary tract infection diagnostics in oncology: reliability of reflex urine culture in immunosuppressed neutropenic and non-neutropenic cancer patients. Clin Infect Dis. 2025 Jun 4;80(5):969-74. Abstract

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84. Siddiqui NS, Khan Z, Khan MS, et al. Trends in incidence and outcomes of Clostridium difficile Colitis in hospitalized patients of febrile neutropenia: a nationwide analysis. J Clin Gastroenterol. 2019 Oct;53(9):e376-81. Abstract

85. Satlin MJ, Cohen N, Ma KC, et al. Bacteremia due to carbapenem-resistant Enterobacteriaceae in neutropenic patients with hematologic malignancies. J Infect. 2016 Oct;73(4):336-45. Abstract

86. Uys A, Rapoport BL, Anderson R. Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer (MASCC) risk-index score. Support Care Cancer. 2004 Aug;12(8):555-60. Abstract

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90. Koenig C, Schneider C, Morgan JE, et al. Association of time to antibiotics and clinical outcomes in patients with fever and neutropenia during chemotherapy for cancer: a systematic review. Support Care Cancer. 2020 Mar;28(3):1369-83. Abstract

91. Monuszko KA, Albright B, Katherine Montes De Oca M, et al. Evaluation of the clinical index of stable febrile neutropenia risk stratification system for management of febrile neutropenia in gynecologic oncology patients. Gynecol Oncol Rep. 2021 Aug;37:100853.Full text  Abstract

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107. Escalante CP, Weiser MA, Manzullo E, et al. Outcomes of treatment pathways in outpatient treatment of low risk febrile neutropenic cancer patients. Support Care Cancer. 2004 Sep;12(9):657-62. Abstract

108. Kern WV, Marchetti O, Drgona L, et al. Oral antibiotics for fever in low-risk neutropenic patients with cancer: a double-blind, randomized, multicenter trial comparing single daily moxifloxacin with twice daily ciprofloxacin plus amoxicillin/clavulanic acid combination therapy - EORTC infectious diseases group trial XV. J Clin Oncol. 2013 Mar 20;31(9):1149-56.Full text  Abstract

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