Pediatric FN Definition 2012 Bern
Pediatric FN Definition 2012 Bern The Impact of Lowering Fever Limits on the Rate of Fever in Chemotherapy-induced Neutropenia (FN). A Prospective Single-center Observational Study in Children and Adolescents With Cancer.
STUDY AIMS Based on prospectively collected information on ear temperatures, ANC values, emergency calls and consultations for fever, and on hospitalizations for FN in children and adolescents with cancer
- to describe the frequency of episodes of FN, and of other clinically relevant FN-related measures
- to compare these frequencies and measures in reality vs. applying Bernese standard limits for defining fever (ear temperature ≥39.0°C)
- to compare these frequencies and measures applying the Bernese standard limit of ≥39.0°C (LimitStandard) vs. a range of hypothetically lower limits defining fever (LimitLow)
- to determine if it would be useful to perform an interventional study on the question of different fever limits, powered to study both efficacy (frequency of FN) and safety (AE in delayed FN diagnosis)
- to use the platform of this prospective study to explore if the serum level of cortisol is associated with adverse events in FN
HYPOTHESIS In children and adolescents with cancer, hypothetically modifying the definitions of fever from ear temperature 39.0°C to lower limits would
- increase the rate of FN episodes diagnosed during chemotherapy (primary endpoint).
- increase the rate of other clinically important FN-related measures related to chemotherapy exposure time (secondary endpoints 1,2,3) and outcome/treatment-related measures during treatment of FN episodes diagnosed in reality (secondary endpoints 4,5,6).
- not relevantly decrease the proportion of FN with AE (secondary endpoint 7).
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Studientyp
Studientyp
Einschreibung (Tatsächlich)
Einschreibung
Kontakte und Standorte
Studienorte
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Bern, Schweiz, CH-3010
- Division of Hematology/Oncology, Department of Pediatrics, University of Bern / Inselspital
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- >1 year and ≤17 years at time of recruitment
- Chemotherapy treatment because of any malignancy for at least 2 months at time of recruitment
- Written informed consent from patients and/or parents for the study
Exclusion Criteria:
- Infants ≤1 year old (reason: differences in standard fever limit and method to measure temperature)
- Denied written informed consent from patients and/or parents for the study
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Anzahl der Gruppen / Kohorten
Kohorten und Interventionen
Gruppe / KohorteGruppe / Kohorte |
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Patients
Pediatric patients with cancer, receiving standard chemotherapy, and receiving standard supportive therapy in case of fever in neutropenia (FN) (No intervention for study purposes)
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
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Rate ratio of additional episodes of FN diagnosed (applying LimitLow vs. LimitStandard)
Zeitfenster: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
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Rate of episodes of fever
Zeitfenster: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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(Protocol: 1)
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until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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Rate of emergency calls for fever
Zeitfenster: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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(Protocol: 2a)
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until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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Rate ratio of FN diagnosed earlier (applying LimitLow vs. LimitStandard)
Zeitfenster: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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(Protocol: 3)
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until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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Proportion of FN with blood cultures performed after start of antibiotics (AB) for prolonged fever
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 4a)
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until end of AB therapy for FN (estimated median, 4 days)
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Proportion of FN with delayed hospital discharge for prolonged fever
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 5) (Low risk FN episodes with first-day stepping down will be excluded from this analysis.)
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until end of AB therapy for FN (estimated median, 4 days)
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Time point of empirical AB switch for prolonged fever during FN
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 6a)
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until end of AB therapy for FN (estimated median, 4 days)
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Proportion of FN with any adverse event
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 7a)
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until end of AB therapy for FN (estimated median, 4 days)
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Serum level of cortisol
Zeitfenster: at presentation with FN (in reality)
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(Protocol: 8)
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at presentation with FN (in reality)
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Proportion of FN with switch of empirical AB for prolonged fever
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 4b)
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until end of AB therapy for FN (estimated median, 4 days)
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Proportion of FN with add-on of empirical antifungal therapy for prolonged fever
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 4c)
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until end of AB therapy for FN (estimated median, 4 days)
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Rate of emergency CBC with consultation for fever
Zeitfenster: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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(Protocol: 2b)
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until 2 weeks after last dose of chemotherapy (expected median, 6 months)
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Time point of starting empirical antifungal therapy for prolonged fever during FN
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 6b)
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until end of AB therapy for FN (estimated median, 4 days)
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Proportion of FN with bacteremia
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 7b)
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until end of AB therapy for FN (estimated median, 4 days)
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Proportion of FN with serious medical complication
Zeitfenster: until end of AB therapy for FN (estimated median, 4 days)
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(Protocol: 7c)
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until end of AB therapy for FN (estimated median, 4 days)
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Studienstuhl: Roland A Ammann, MD, Pediatric Hematology/Oncology, Department of Pediatrics, University of Bern, Bern, Switzerland
Publikationen und hilfreiche Links
Allgemeine Veröffentlichungen
- Ammann RA, Teuffel O, Agyeman P, Amport N, Leibundgut K. The influence of different fever definitions on the rate of fever in neutropenia diagnosed in children with cancer. PLoS One. 2015 Feb 11;10(2):e0117528. doi: 10.1371/journal.pone.0117528. eCollection 2015.
- Wagner S, Brack EK, Stutz-Grunder E, Agyeman P, Leibundgut K, Teuffel O, Ammann RA. The influence of different fever definitions on diagnostics and treatment after diagnosis of fever in chemotherapy-induced neutropenia in children with cancer. PLoS One. 2018 Feb 20;13(2):e0193227. doi: 10.1371/journal.pone.0193227. eCollection 2018.
- Brack E, Wagner S, Stutz-Grunder E, Agyeman PKA, Ammann RA. Temperatures, diagnostics and treatment in pediatric cancer patients with fever in neutropenia, NCT01683370. Sci Data. 2020 May 26;7(1):156. doi: 10.1038/s41597-020-0504-9.
- Lavieri L, Koenig C, Teuffel O, Agyeman P, Ammann RA. Temperatures and blood counts in pediatric patients treated with chemotherapy for cancer, NCT01683370. Sci Data. 2019 Jul 3;6(1):108. doi: 10.1038/s41597-019-0112-8.
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn
Studienbeginn
Primärer Abschluss (Tatsächlich)
Primärer Abschluss
Studienabschluss (Tatsächlich)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Schätzen)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- PFND2012B
- KFS-2933-02-2012 (Andere Zuschuss-/Finanzierungsnummer: Krebsforschung Schweiz)
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