Cancer treatment with chemotherapy, radiation therapy, surgery, and biologic therapy puts patients at risk for development of infection. Compromised immune function associated with treatment can affect morbidity and mortality.
Prevention of infection in patients with cancer focuses on interventions to prevent infection because of neutropenia or other immune deficiency related to malignancy or its treatment. The risk of infection is associated with the degree and duration of neutropenia. More than 50% of patients with neutropenia can be expected to develop infection. Evidence included here is focused on preventing interventions, rather than treatment of infection or febrile neutropenia.
Click here for instructions on navigating the ONS PEP webpages. This topic was updated on December 15, 2015.
Patients receiving standard chemotherapy regimens for solid tumors are at lower risk for development of febrile neutropenia and infection than patients who undergo bone marrow or stem cell transplantation. Interventions in these two different groups of patients for the prevention of infection can be expected to differ substantially in terms of level of effectiveness. PEP resources and evidence categorization is grouped for general patients with cancer and patients undergoing high-dose chemotherapy and bone marrow or any type of stem cell transplantation separately. This general section is applicable to any patients that are not undergoing transplantation.
Autologous hematopoietic stem cell transplant (HSCT) recipients tend to have fewer infectious complications than allogeneic transplant recipients; however, defects in cell-mediated immunity can continue for months, even in uncomplicated HSCTs of both types. Patients undergoing transplantation are at high risk for infection with a variety of pathogens at multiple phases in their care. This section includes evidence for preventing infections in the transplant patient population.