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).
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Todellinen)
Ilmoittautuminen
Yhteystiedot ja paikat
Opiskelupaikat
-
-
-
Bern, Sveitsi, CH-3010
- Division of Hematology/Oncology, Department of Pediatrics, University of Bern / Inselspital
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
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
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Ryhmien/kohorttien lukumäärä
Kohortit ja interventiot
Ryhmä/KohorttiRyhmä/Kohortti |
|---|
|
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)
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
|
Rate ratio of additional episodes of FN diagnosed (applying LimitLow vs. LimitStandard)
Aikaikkuna: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
Toissijaiset tulostoimenpiteet
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Rate of episodes of fever
Aikaikkuna: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
(Protocol: 1)
|
until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
|
Rate of emergency calls for fever
Aikaikkuna: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
(Protocol: 2a)
|
until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
|
Rate ratio of FN diagnosed earlier (applying LimitLow vs. LimitStandard)
Aikaikkuna: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
(Protocol: 3)
|
until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
|
Proportion of FN with blood cultures performed after start of antibiotics (AB) for prolonged fever
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 4a)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Proportion of FN with delayed hospital discharge for prolonged fever
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 5) (Low risk FN episodes with first-day stepping down will be excluded from this analysis.)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Time point of empirical AB switch for prolonged fever during FN
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 6a)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Proportion of FN with any adverse event
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 7a)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Serum level of cortisol
Aikaikkuna: at presentation with FN (in reality)
|
(Protocol: 8)
|
at presentation with FN (in reality)
|
|
Proportion of FN with switch of empirical AB for prolonged fever
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 4b)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Proportion of FN with add-on of empirical antifungal therapy for prolonged fever
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 4c)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Rate of emergency CBC with consultation for fever
Aikaikkuna: until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
(Protocol: 2b)
|
until 2 weeks after last dose of chemotherapy (expected median, 6 months)
|
|
Time point of starting empirical antifungal therapy for prolonged fever during FN
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 6b)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Proportion of FN with bacteremia
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 7b)
|
until end of AB therapy for FN (estimated median, 4 days)
|
|
Proportion of FN with serious medical complication
Aikaikkuna: until end of AB therapy for FN (estimated median, 4 days)
|
(Protocol: 7c)
|
until end of AB therapy for FN (estimated median, 4 days)
|
Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Yhteistyökumppanit
Yhteistyökumppanit
Tutkijat
Tutkijat
- Opintojen puheenjohtaja: Roland A Ammann, MD, Pediatric Hematology/Oncology, Department of Pediatrics, University of Bern, Bern, Switzerland
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- 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.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Ensisijainen valmistuminen
Opintojen valmistuminen (Todellinen)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- PFND2012B
- KFS-2933-02-2012 (Muu apuraha/rahoitusnumero: Krebsforschung Schweiz)
Nämä tiedot haettiin suoraan verkkosivustolta clinicaltrials.gov ilman muutoksia. Jos sinulla on pyyntöjä muuttaa, poistaa tai päivittää tutkimustietojasi, ota yhteyttä register@clinicaltrials.gov. Heti kun muutos on otettu käyttöön osoitteessa clinicaltrials.gov, se päivitetään automaattisesti myös verkkosivustollemme .