National Comprehensive Cancer Network

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NCCN Updates Prevention and Treatment of Cancer-Related Infections Guidelines

JENKINTOWN, Pa., April 30, 2007 — The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology™ are developed and updated continually by multidisciplinary panels of expert physicians from NCCN Member Institutions. Reflecting this constant expansion and improvement, NCCN announces important updates to the NCCN Fever and Neutropenia Guidelines.

The first change is that the guidelines have a new name: “Prevention and Treatment of Cancer-Related Infections.” Prior NCCN guidelines on infections in patients with cancer focused primarily on the management of fever and neutropenia. The new name and expanded focus come in response to the complexity of immunocompromised conditions in patients with cancer and the spectrum of pathogens to which they are susceptible. New prevention and treatment recommendations have been added for other highly immunocompromised patients with cancer such as allogeneic hematoptoietic stem cell transplant recipients, patients with or at risk for graft-versus-host disease, and patients receiving high-dose corticosteroids, purine analogues and alemtuzumab.

The panel also expanded the categories applied to assessment of risk of infections. These general categories are based on observational studies, duration of neutropenia, underlying disease, intensity of chemotherapy and other immunomodulatory therapies. Host factors were used to stratify the risk for specific infectious complications and were incorporated into new algorithms for prophylaxis, diagnosis and early therapy in specific patient groups.

The panel also modified their recommendations related to prophylaxis and early treatment of specific infectious diseases. These new recommendations are based on the availability of newer antibiotic agents and diagnostics and recent clinical trial data. The new guidelines address the benefits and trade-offs of quinolone prophylaxis in neutropenic patients in light of new data from randomized studies. In addition, the availability of newer broad spectrum antifungal agents with a good safety profile raise the possibility of using mold-active prophylaxis in patients at high risk for invasive fungal infections without the need to empirically modify antifungal therapy solely on persistent neutropenic fever of unknown etiology. Algorithms that include chest CT scans and laboratory surrogates for invasive fungal infections are also discussed in the updated guidelines.

The NCCN Clinical Practice Guidelines in Oncology™ are widely recognized and applied as the standard of care in oncology in the United States in both the community and the academic practice settings. The most recent version of this and all the guidelines are available free of charge at

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives. For more information, visit

The NCCN Member Institutions are:

  • Fred & Pamela Buffett Cancer Center
  • Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
  • City of Hope Comprehensive Cancer Center
  • Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center
  • Duke Cancer Institute
  • Fox Chase Cancer Center
  • Huntsman Cancer Institute at the University of Utah
  • Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
  • The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
  • Robert H. Lurie Comprehensive Cancer Center of Northwestern University
  • Mayo Clinic Cancer Center
  • Memorial Sloan Kettering Cancer Center
  • Moffitt Cancer Center
  • The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
  • Roswell Park Cancer Institute
  • Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
  • St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
  • Stanford Cancer Institute
  • University of Alabama at Birmingham Comprehensive Cancer Center
  • UC San Diego Moores Cancer Center
  • UCSF Helen Diller Family Comprehensive Cancer Center
  • University of Colorado Cancer Center
  • University of Michigan Comprehensive Cancer Center
  • The University of Texas MD Anderson Cancer Center
  • University of Wisconsin Carbone Cancer Center
  • Vanderbilt-Ingram Cancer Center
  • Yale Cancer Center/Smilow Cancer Hospital