Klastersky Jean, Paesmans Marianne
Institut Jules Bordet, Oncology Program for the Brussels Public Hospitals, Brussels, Belgium.
Support Care Cancer. 2007 May;15(5):477-82. doi: 10.1007/s00520-006-0185-8. Epub 2007 Feb 9.
Among patients who develop fever and neutropenia after having received cancer chemotherapy, we have to distinguish at least three categories of risk levels for complications and death: patients at low risk and eligible for oral treatment and possibly outpatient management, patients at low risk who require intravenous therapy, and patients at higher risk.
The Multinational Association for Supportive Care in Cancer scoring system identifies patients at low risk (<5%) of severe complications with very low mortality (<1%) during an episode of febrile neutropenia; this group represents roughly 70% of an unselected population of patients with febrile neutropenia. A significant percentage (approximately 50%) of these patients are eligible for treatment with orally administered antibiotics and can be discharged early and safely from the hospital after a short (24-48 h) observation period.
在接受癌症化疗后出现发热和中性粒细胞减少的患者中，我们至少要区分出三类并发症和死亡风险水平：低风险且适合口服治疗并可能进行门诊管理的患者、低风险但需要静脉治疗的患者以及高风险患者。
癌症支持治疗多国协会评分系统可识别出发热性中性粒细胞减少发作期间严重并发症风险低（<5%）且死亡率极低（<1%）的患者；这一组约占未筛选的发热性中性粒细胞减少患者群体的70%。这些患者中有相当比例（约50%）适合口服抗生素治疗，经过短时间（24 - 48小时）观察期后可提前安全出院。
