{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T20:41:03Z","timestamp":1788381663685,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T00:00:00Z","timestamp":1677196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000097","name":"National Center for Research Resources","doi-asserted-by":"publisher","award":["KL2TR000446"],"award-info":[{"award-number":["KL2TR000446"]}],"id":[{"id":"10.13039\/100000097","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2023,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The optimal management of febrile stem cell transplant (SCT) patients presenting without severe neutropenia (absolute neutrophil count [ANC]\u00a0\u2265\u00a0500\/\u00b5L) is unclear. The authors have developed iterative risk prediction models (Esbenshade Vanderbilt [EsVan] models) that reliably predict bloodstream infections (BSIs) in the febrile general pediatric oncology population without severe neutropenia, but SCT\u2010specific data are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All SCTs occurring from May 2005 to November 2019 at a single institution were identified. Episodes of fever with a central venous catheter and ANC values \u2265 500\/\u00b5L were abstracted. All previous versions of the EsVan model were applied to the SCT data, and c\u2010statistics were generated. The models were additionally applied to each type of transplant (autologous\/allogeneic), and a new allogeneic model that further adjusted for metrics of immunosuppression, Esbenshade Vanderbilt Allogeneic SCT Model\u00a0(EsVanAlloSCT), was developed and internally validated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For 429 SCT episodes (221 autologous and 208 allogeneic), the BSI incidence was 19.6% (84 of 429), and it was higher in allogeneic transplant patients (25.5%) than autologous transplant patients (14.0%; <jats:italic>p<\/jats:italic>\u00a0&lt; .01). All versions of the EsVan model performed well for the overall SCT cohort (c\u2010statistics, 0.759\u20130.795). The EsVan models performed better for the autologous episodes (c\u2010statistics, 0.869\u20130.881) than the allogeneic SCT episodes (c\u2010statistics, 0.678\u20130.717). The new allogeneic transplant\u2013specific model, EsVanAlloSCT, which added an adjustment for the extent of immunosuppression, yielded a c\u2010statistic of 0.792 (bootstrap\u2010corrected, 0.750).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The EsVan models work exceptionally well when they are applied to autologous SCT, but they work less well for allogeneic SCT. EsVanAlloSCT appears to improve the predictive ability in allogeneic SCT, but it will need additional external validation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34703","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T22:55:47Z","timestamp":1677279347000},"page":"1591-1601","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Applying a risk prediction model for bloodstream infection in a febrile, nonseverely neutropenic cohort of pediatric stem cell transplant patients"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1921-6616","authenticated-orcid":false,"given":"Kasey","family":"Jackson","sequence":"first","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Anderson","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiguo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Statistics Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie L.","family":"Kitko","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Connelly","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard H.","family":"Ho","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Infectious Disease  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Dulek","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Infectious Disease  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra L.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0154-4996","authenticated-orcid":false,"given":"Adam J.","family":"Esbenshade","sequence":"additional","affiliation":[{"name":"Monroe Carell Jr Children\u2019s Hospital Vanderbilt Division of Pediatric Hematology\u2013Oncology and Vanderbilt\u2010Ingram Cancer Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,24]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473\u20103099(18)30600\u20105"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399\u20103062.2005.00088.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2010.112"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.03.019"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/bbmt.2002.v8.pm12374456"},{"issue":"2","key":"e_1_2_9_7_1","first-page":"89","article-title":"Epidemiology and risk factors for bloodstream infections after allogeneic hematopoietic stem cell transplantion","volume":"30","author":"Cappellano P","year":"2007","journal-title":"New 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