{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:54:28Z","timestamp":1777596868698,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T00:00:00Z","timestamp":1627257600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fever in neutropenia (FN) remains a frequent complication in pediatric patients undergoing chemotherapy for cancer. Preventive strategies, like primary antibiotic prophylaxis, need to be evidence\u2010based.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Data on pediatric patients with any malignancy from the prospective multicenter SPOG 2015 FN Definition Study (NCT02324231) were analyzed. A score predicting the risk to develop FN with safety\u2010relevant events (SRE; bacteremia, severe sepsis, intensive care unit admission, death) was developed using multivariate mixed Poisson regression. Its predictive performance was assessed by internal cross\u2010validation and compared with the performance of published rules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In 238 patients, 318 FN episodes were recorded, including 53 (17%) with bacteremia and 68 (21%) with SRE. The risk\u2010prediction score used three variables: chemotherapy intensity, defined according to the expected duration of severe neutropenia, time since diagnosis, and type of malignancy. Its cross\u2010validated performance, assessed by the time needed to cover (TNC) one event, exceeded the performance of published rules. A clinically useful score threshold of \u226511 resulted in 2.3% time at risk and 4.1\u00a0months TNC. Using external information on efficacy and timing of intermittent antibiotic prophylaxis, 4.3\u00a0months of prophylaxis were needed to prevent one FN with bacteremia, and 5.2\u00a0months to prevent one FN with SRE, using a threshold of \u226511.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This score, based on three routinely accessible characteristics, accurately identifies pediatric patients at risk to develop FN with SRE during chemotherapy. The score can help to design clinical decision rules on targeted primary antibiotic prophylaxis and corresponding efficacy studies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.29253","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T13:46:47Z","timestamp":1627307207000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Predicting fever in neutropenia with safety\u2010relevant events in children undergoing chemotherapy for cancer: The prospective multicenter SPOG 2015 FN Definition Study"],"prefix":"10.1002","volume":"68","author":[{"given":"Luana","family":"Lavieri","sequence":"first","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Pediatrics Inselspital, Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-5183","authenticated-orcid":false,"given":"Christa","family":"Koenig","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Pediatrics Inselspital, Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Bodmer","sequence":"additional","affiliation":[{"name":"Pediatric Oncology, University Children's Hospital of Z\u00fcrich University of Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp K. A.","family":"Agyeman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Inselspital, Bern University Hospital University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Scheinemann","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Pediatrics Kantonsspital Aarau  Aarau Switzerland"},{"name":"University of Basel  Basel Switzerland"},{"name":"Department of Pediatrics McMaster Children's Hospital and McMaster University  Hamilton Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Ansari","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Women, Child and Adolescent University Hospital of Geneva  Geneva Switzerland"},{"name":"Department of Pediatrics, Gynecology, and Obstetrics, Cansearch Research Platform of Pediatric Oncology and Hematology, Faculty of Medicine University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4022-4917","authenticated-orcid":false,"given":"Jochen","family":"Roessler","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Pediatrics Inselspital, Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1902-2352","authenticated-orcid":false,"given":"Roland A.","family":"Ammann","sequence":"additional","affiliation":[{"name":"Pediatric Hematology\/Oncology, Department of Pediatrics Inselspital, Bern University Hospital, University of Bern  Bern Switzerland"},{"name":"Kinderaerzte KurWerk  Burgdorf Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-64-2-328"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.7017"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminoncol.2020.02.005"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.2395"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1082"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(20)30725-7"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.12512"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30092-4"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_9_11_1","unstructured":"SPOG 2015 FN Definition Protocol.Swiss Paediatric Oncology Group.2016. 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