Challenges in prevention, early detection, and management of febrile neutropenia in adult patients with solid tumors

Febrile neutropenia (FN) is a common oncologic emergency where quick patient assessment and prompt initiation of antimicrobial treatment is crucial. Guidelines provide detailed recommendations on prevention and treatment; however, their real-world implementation can prove to be difficult. Score systems for outcome risk are effective in identifying low-risk patients with FN. After initiation of therapy, regular re-evaluation of antimicrobial treatment is necessary, and further diagnostic studies should be tailored to each patient. Use of granulocyte colony-stimulating factor (G-CSF) prophylactically in chemotherapy regimens with intermediate FN risk as well as therapeutically in patients with manifest FN is variable in clinical practice and needs to be better defined. Future steps of reducing risk of FN involve investigating underlying genetic factors. Regarding early detection of FN, patient education is paramount. This short review gives an overview of current guidelines and highlights key challenges in management of FN.