title: [Management of febrile neutropenias in adolescents and young adults: Differences of practice between adult and pediatric units].
abstract: BACKGROUND
  Adolescents and young adults (AYA, 15-25years old) with cancer are treated either in adult or pediatric units. Management of febrile neutropenia (FN) is different between these units. Monitoring rules and indications of hospitalization are often stricter in pediatrics. This study evaluates if these differences influence the occurrence of complications.
  
  
  METHODS
  The medical records of AYA patients treated in our institution in the Euro-E-W-I-N-G99 protocol between 01/09/2000 and 31/05/2013 were retrospectively analyzed. We studied febrile neutropenias occurring after VIDE courses, during the induction period.
  
  
  RESULTS
  Forty-four patients were included (18 from adult units, 26 from pediatrics). Median age at inclusion was 19.6. After 260 courses of VIDE, we observed a median of 2 FN per adult and 3 per pediatric patient (P=0.2). Hospitalization occurred in median 1.5 time per adult and 3 per pediatric patient (P=0.008). Median cumulated length of stay was 4.5days for adults versus 16 days for pediatric patients (P=0.008). There was no significant difference for survival, number of documented infections, transfusions, dose modifications, chemotherapy delay, need for intensive care, infection after post-induction surgery.
  
  
  CONCLUSIONS
  AYA treated in adult services are less frequently hospitalized for FN with no difference in morbi-mortality. Homogeneous recommendations could be made for these patients, whatever the units they are treated in.
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France; Université Claude-Bernard Lyon 1 69008 Lyon, France. Electronic address: p.mathilde@free.fr.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Penel-Page
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: Charline
authors.initials: C
authors.lastname: Normand
authors.affiliation: Institut d'hématologie et d'oncologie pédiatrique (IHOP), 1, place Joseph-Renaut, 69008 Lyon, France.
authors.forename: Amandine
authors.initials: A
authors.lastname: Bertrand
authors.affiliation: Centre Léon-Bérard (CLB), 28, rue Laennec, 69008 Lyon, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Levard
authors.affiliation: Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France.
authors.forename: Helen
authors.initials: H
authors.lastname: Boyle
authors.affiliation: Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France.
authors.forename: Christèle
authors.initials: C
authors.lastname: Riberon
authors.affiliation: Dispositif adolescents-jeunes adultes, commun au CLB et à l'IHOP (DAJAC), 28, rue Laennec, 69008 Lyon, France; Université Claude-Bernard Lyon 1 69008 Lyon, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Marec-Berard
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001859:Bone Neoplasms / Q000188:drug therapy*; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology* / Q000401:mortality; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D060828:Induction Chemotherapy / Q000009:adverse effects*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy*; D016019:Survival Analysis; D055815:Young Adult
keywords: Adolescents; Aplasie fébrile; Febrile neutropenia; Home care; Hospitalisation à domicile; Jeunes adultes; Oncologie; Oncology service; Outpatient; Young adults