Bells Palsy

Infection, frequently presenting as fever and neutropenia (FN), is the most common complication of the treatment of childhood cancer and the leading cause of unplanned hospital admissions. In contrast to adult patients with cancer, there is no validated clinical decision rule (CDR) that reliably identifies children at low and high risk of a severe infection. The current standard of treatment is admission of all children with FN, irrespective of underlying risk, for intravenous antibiotics until resolution of fever and recovery of neutrophil count. While this approach produces low mortality rates, it does over-treat up to 75% of children who do not have a documented infection.

Identifying these low-risk individuals and adopting a personalised approach to FN with reduced intensity treatment and early discharge will minimise the burden of FN on the child, their family and the healthcare system. The aim of this project is to identify a clinical decision rule (CDR) that reliably stratifies children with cancer and fever and neutropenia (FN) into low and high risk for severe infection so as to optimise their management and quality of life and improve resource allocation.

Study design

Multi-centre, prospective observational study

Chief Investigator

Karen Thursky

Time frame

2016 – 2018


National Health and Medical Research Council (project)

Site locations

  • Royal Children’s Hospital, Melbourne
  • John Hunter Children’s Hospital, Newcastle
  • Lady Cilento Children’s Hospital, Brisbane
  • Monash Children’s Hospital, Melbourne
  • Children’s Hospital Westmead, Sydney
  • Sydney Children’s Hospital, Sydney
  • Women’s and Children’s Health Network, Adelaide
  • Perth Children’s Hospital/Princess Margaret Hospital, Perth


845 children < 18years with febrile neutropaenia

Clinical trial registrations

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Gabrielle Haeusler,