Clinical and laboratory features predicting a favorable outcome and allowing early discharge in cancer patients with low-risk febrile neutropenia: A literature review

To value feasibility of early discharge in febrile granulocytopenic patient s, 27 original paper published in the last 11 years were analyzed concernin g these clinical and therapeutic approaches. A Medline search of English la nguage literature published in the last 11 years (1988-1999) used the key w ords neutropenia, fever, cancer, home-antibiotic therapy, short course of a ntibiotic therapy, and early discharge. Twenty-seven original papers fulfil ling the study criteria were identified. In these studies, 5208 episodes we re evaluated: there were 538 failures with 87 deaths. Features of low-risk patients who developed life-threatening infectious disease were related to general clinical condition, cancer control, bone marrow function, presence of clinical signs of infection, and social features. Careful risk assessmen t can allow safe recognition of low-risk patients with febrile neutropenia who can be discharged early and can be used to follow outpatient treatment programs to improve patients' quality of life as well as the use of economi c resources.