JCO Global Oncology (Nov 2020)

Guidance Statement for the Management of Febrile Neutropenia in Pediatric Patients Receiving Cancer-Directed Therapy in Central America and the Caribbean

  • Mario Melgar,
  • Tea Reljic,
  • Guillermo Barahona,
  • Kattia Camacho,
  • Alicia Chang,
  • Johanny Contreras,
  • Darrell Espinoza,
  • Dora Estripeaut,
  • Mario Gamero,
  • Marco Luque,
  • Girlande Mentor,
  • Pamela Zacasa,
  • Maysam Homsi,
  • Miguela A. Caniza,
  • Ambuj Kumar,
  • Sheena Mukkada

DOI
https://doi.org/10.1200/JGO.19.00329
Journal volume & issue
no. 6
pp. 508 – 517

Abstract

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PURPOSEOur objective was to provide regionally appropriate, resource-conscious recommendations for the diagnosis and treatment of pediatric patients with febrile neutropenia.METHODSA multinational panel of Central American and Caribbean clinicians who deliver pediatric oncology care prioritized clinically important questions and then used the Grading of Recommendations Assessment, Development and Evaluation methodology to provide recommendations on the selected topics.RESULTSTwenty-two questions and 2 definitions were included in the guideline, which was intended to establish minimum care standards for pediatric patients treated in regional centers. Of all the included studies, 6.9% were conducted in low- and middle-income countries, and no studies were performed in countries represented on the panel.CONCLUSIONThe panel made recommendations on the basis of existing evidence but identified important gaps in knowledge from the region and from resource-limited settings that may affect the clinical applicability of these recommendations. These deficiencies suggest a research agenda that will enable future guidelines to be more responsive to the local context.