Use of biomarkers in the management of febrile neutropenia episodes in children with cancer☆

lthough the diagnosis and treatment of febrile neutropeia episodes have improved significantly over the past two ecades, sepsis is still a major cause of mortality and morbidty in patients undergoing chemotherapy regimens that cause ntensive myelosuppression.1–4 Even in institutions where arly initiation of antibiotic therapy and advances in suportive measures have significantly reduced the mortality ssociated with infections, there is great concern about the orbidity related to these complications.5 Other important spects to be considered are the high costs associated with reatment and impaired quality of life of the patients and heir family, attributable to the need for prolonged or repeated ospitalizations.6 Therefore, it is extremely important to develop risktratification models that can predict the following conditions arly, that is, at admission or within 48 h of evaluation: (1) hildren at low risk for developing severe infections who can ave a reduced intensity of antibiotic therapy and/or a shorter ospital stay; and (2) children at high risk of developing comlications and death who need more aggressive therapeutic easures.3,7 Although their use is well established in adult patients, here is still no consensus on scores and strategies for redicting the risk for infection and complications in children ith cancer who present with febrile neutropenia.7 The use