2. Jeśli ANC wynosi ≤0,5 × 109/l, nie obserwuje się powikłań, pacjent nie gorączkuje przez 5-7 dni, można odstawić leki przeciwbakteryjne (z wyjątkiem sytuacji wysokiego ryzyka: ostra białaczka, po podaniu dużej dawki ChT, gdy leki przeciwbakteryjne są często kontynuowane do 10 dni lub do momentu, w którym ANC wynosi ≥0,5 × 109/l) [II, A].


Pacjenci z uporczywą gorączką (pomimo stężenia neutrofili ANC wynoszącego ≥0,5 × 109/l) powinni być konsultowani przez specjalistę chorób zakaźnych oraz należy rozważyć leczenie przeciwgrzybicze [II, A].

Podsumowanie

Gorączka neutropeniczna to złożony problem kliniczny, który może być leczony efektywnie jedynie dzięki wdrożeniu odpowiedniego postępowania. Zastosowanie się do zaleceń ESMO i szybkie zastosowanie leczenia może poprawić rokowanie pacjentów onkologicznych.

ABSTRACT

Despite progress in treatment and prevention, febrile neutropenia remains a major clinical problem in oncological practice. It is one of the dominant reasons of decreased treatment efficacy in oncology, causing delays and dose reductions in chemotherapy. This article presents the 2016 ESMO guidelines on „Management of Febrile Neutropenia” for clinicians.

KEYWORDS: febrile neutropenia, candidiasis, invasive aspergillosis, MDR, ANC, G-CSF, colony-stimulating agents, supportive care, infections, pneumocystosis, central vein catheter.

Zdjęcie: archiwum prywatne

Piśmiennictwo

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