Supportive Care in Cancer

, Volume 21, Issue 5, pp 1241–1251 | Cite as

Developing a national ‘low risk’ febrile neutropenia framework for use in children and young people's cancer care

  • F GibsonEmail author
  • J Chisholm
  • E Blandford
  • P Donachie
  • J Hartley
  • S Lane
  • K Selwood
  • R Skinner
  • R Phillips
  • on behalf of the CCLG Supportive Care Group
Original Article



A Delphi study was undertaken to develop a framework guidance that would rationalise and standardise the care of children with febrile neutropenia (FNP) across the UK.


A mailed Delphi survey was undertaken with health professionals working in children's cancer units. The survey employed two rounds of feedback on 22 practice statements drawn from a systematic review of clinical evidence. Consensus was assumed for any statement where 80+ % of respondents indicated that they “agreed” or “strongly agreed”.


Consensus was reached on 21 of the 22 practice statements in round 1 that were categorised into six areas: definition of fever and neutropenia, initial management and choice of antibiotic, defining low-risk patients, strategy in low-risk patients and alternative approaches. Consensus could not be reached on whether patients needed to be afebrile to be suitable for discharge and the required length of outpatient antibiotic treatment.


A Delphi survey allowed the successful development of a national framework for identification and management of children with FNP. The use of an existing well-functioning professional network was key in this project's success.


Children Febrile neutropenia Delphi survey Practice framework 



The authors would like to thank the Coordinating Centre: Children's Cancer & Leukaemia Group, CCLG Data Centre, University of Leicester, Leicester, which support the CCLG Supportive Care Group. Thanks also go to CCLG centres that participated in the study.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • F Gibson
    • 1
    Email author
  • J Chisholm
    • 2
  • E Blandford
    • 3
  • P Donachie
    • 3
  • J Hartley
    • 4
  • S Lane
    • 5
  • K Selwood
    • 6
  • R Skinner
    • 7
  • R Phillips
    • 8
  • on behalf of the CCLG Supportive Care Group
  1. 1.Great Ormond Street Hospital for Children NHS Foundation Trust and London South Bank UniversityLondonUK
  2. 2.Children and Young People’s DepartmentRoyal Marsden Hospital NHS Foundation TrustSuttonUK
  3. 3.Children’s Cancer and Leukaemia GroupUniversity of LeicesterLeicesterUK
  4. 4.Department of Microbiology, Virology and Infection ControlGreat Ormond Street Hospital for Children NHS TrustLondonUK
  5. 5.Children’s Oncology UnitChildren’s HospitalOxfordUK
  6. 6.Alder Hey Children’s NHS Foundation Trust HospitalLiverpoolUK
  7. 7.Great North Children’s HospitalNewcastle upon Tyne Hospitals NHS Foundation TrustNewcastle upon TyneUK
  8. 8.University of York and Leeds General InfirmaryLeedsUK

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