Fever and neutropenia is a common and potentially life-threatening toxicity of therapy for many pediatric oncology patients. Traditionally, these patients have been managed as inpatients for administration of empiric IV antibiotics and for close monitoring. There is, however, substantial data to support risk stratification, as well as treatment with oral antibiotics and care in the outpatient setting. Within Ontario, some tertiary centres have moved to treating a select group of patients meeting low-risk criteria with oral antibiotics as outpatients. While this is not an expected service to be offered by satellites, many have voiced interest in developing similar programs. This round table discussion will provide an overview of the steps required to implement outpatient management of fever and neutropenia and discuss the associated challenges and opportunities.
MD, Clinical Director,
Division of Haematology/Oncology,
The Hospital for Sick Children
Dr. Sarah Alexander is a staff clinician in the leukemia/lymphoma section at The Hospital for Sick Children. Dr. Alexander received her medical degree from Harvard Medical School in 1994. She did her pediatric training at Boston Children’s Hospital and her fellowship in hematology and oncology at Boston Children’s Hospital and Dana Farber Cancer Institute. After completing her training, she remained on staff at Dana Farber before moving to the Division of Paediatric Haematology and Oncology at Rainbow Babies and Children’s Hospital in Cleveland, where she was the Director of Inpatient Haematology/Oncology, the Pediatric Haematology/Oncology Fellowship Training Program and the Hemophilia Treatment Centre. Dr. Alexander returned to Canada in 2007 to accept a position at The Hospital for Sick Children where her roles include Clinical Director for the Division of Haematology/Oncology, and participating in clinical research, and caring for children with leukemia and lymphoma.