Viot M, Blanc-Vincent M P, Béal J, Biron P, Boutard P, Malgrange V B, Crokaert F, Escande M C, Fuhrmann C, Lesimple T, Pény J, Pottecher B, Raveneau J, Senet J M, Thyss A
FNCLCC, Opération Standards, Options, Recommandations, Paris.
Presse Med. 2000 Oct 7;29(29):1630-3.
The main risk factors of infectious complications in cancer patients result from immune deficiency more or less related to cancer. Prognosis is related to the type and grade of the underlying disease. Prospective studies should be conducted to update data on the frequency of infections, morbidity and mortality (expert agreement). Prospective studies are needed to follow the epidemiology in cancer patients, particularly in neutropenic patients (expert agreement). Prospective studies should be conducted to determine prognosis factors allowing precise recognition of "low-risk" neutropenic patients with fever who could benefit from home care (expert agreement). When infection is suspected, the first criterion determining the therapeutic attitude concern signs of gravity requiring emergency care (septic shock). Beyond this situation, the first criterion determining the therapeutic attitude is the severity of the neutropenia. Microbial diagnosis is essential for initiating and later adapting anti-infectious treatment as well as for assessing efficacy.
癌症患者发生感染性并发症的主要危险因素或多或少源于与癌症相关的免疫缺陷。预后与基础疾病的类型和分级有关。应开展前瞻性研究以更新关于感染频率、发病率和死亡率的数据（专家共识）。需要开展前瞻性研究以追踪癌症患者尤其是中性粒细胞减少患者的流行病学情况（专家共识）。应开展前瞻性研究以确定预后因素，从而能够精确识别可能受益于居家护理的发热“低风险”中性粒细胞减少患者（专家共识）。当怀疑发生感染时，决定治疗态度的首要标准是需要急诊护理的严重体征（感染性休克）。除此之外，决定治疗态度的首要标准是中性粒细胞减少的严重程度。微生物诊断对于启动和调整抗感染治疗以及评估疗效至关重要。
