Treating Patients with Febrile Neutropenia

Recent developments in a programme of work deciding how best to treat children and young adults with febrile neutropenia have confirmed the policy we already follow here in Leeds. For some years, there has been a debate about whether it was necessary for everyone who came into hospital with a fever and neutropenia to have a chest X ray, or whether doctors could select only those they felt needed them.

 A team led by Dr Bob Phillips undertook a systematic review of the world's research in this area. Their results, due to be published in the Journal of Paediatrics and Child Health, confirmed that doctors are quite good at making the assessment, and not everyone does need an X ray. This advice reduces unnecessary tests, shortens the hassles of admission, and doesn't lead to problems for those who don't get X rayed. (There are still good reasons for some patients to get X rays though and the study has helped clarify these.)

Candlelighters Support for Ifosphamide Study

Ifosphamide chemotherapy can cause significant kidney problems for some children, and a review conducted in 2009 showed a promising test for the early detection of the problem. After a battle with bureaucracy, a joint team of Paediatric Nephrologists and Oncologists will soon be able to start a study to see if a urine test can predict the problem. This work builds on a long tradition of joint projects, and hopefully starts tradition of undertaking new studies when the existing evidence can't give an adequate answer.

Dr Bob Phillips
Locum Consultant in Paediatric Oncology, Leeds Teaching Hospital Trust
MRC Research Fellow, Centre for Reviews and Dissemination, University of York

Glossary

Febrile Neutropenia - fever and no immunity tofight infection

Ifosphamide - cancer drug used for treatingsolid tumours

Oncologist - cancer specialist

Nephrologist - kidney specialist