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Treatment plan helps keep young cancer patients at home during COVID crisis

Posted on 14 June 2020

A new treatment plan is allowing more young cancer patients to recover from mild infections at home – helping to ease pressure on the NHS during the COVID-19 pandemic.

The programme is being trialled in Leeds, London, and Newcastle.

Dr Bob Phillips, from the University of York, is leading the push to roll out the programme in the UK.

The Low-risk Febrile Neutropenia Programme, which was developed by researchers in York and Australia, identifies when young cancer patients with a fever can be treated and supported at home.

Children undergoing cancer treatment face an increased risk of developing febrile neutropenia, a fever with low numbers of a white blood cells which are important in fighting infections.  Febrile neutropenia may require hospital admission for antibiotics, but the international collaboration is working to manage suitable cases at home.

Development 

Dr Phillips, from the University of York’s Centre for Reviews and Dissemination said: “It is early days, but the simple and robust system is already popular with families who have trialled it in Leeds, London, and Newcastle.  

 “Of the 32 children who have presented with febrile neutropenia at Leeds Teaching Hospital so far, nine have gone home with support and an antibiotic treatment plan within a day, compared to a usual minimum hospital stay of three days. Families have embraced the development.

“They absolutely want to get out of hospital quicker. It means that we don’t do unnecessary tests on kids and just annoy them, and they actually do better at home. 

 “It’s been wonderful to have the direct support of paediatric cancer researcher, Dr Haeusler and the Australian teams in implementing this program in the UK. Without her input we’d be struggling to make this work. The more we show it works across different hospitals in different countries, the more robust it is because it’s experiencing variation and being effective.”

 Programme

The programme has been led by Dr Haeusler at Murdoch Children’s Research Institute (MCRI) and the Peter MacCallum Cancer Centre  and is endorsed by the Children’s Cancer and Leukaemia Group (CCLG).

 The system, called AUS-rule (Australia-UK – Switzerland), led to the programme being created and was formulated by Australia’s PICNICC (Predicting Infectious Complications of Neutropenic sepsis In Children with Cancer), the Swiss Paediatric Oncology Group (SPOG) and  the University of York PICNICC project led by Dr Bob Phillips

 Home management

The AUS-rule helps doctors decide which children with febrile neutropenia are suitable for home management using antibiotics and temperature monitoring. It considers platelet and white cell counts and chemotherapy intensity.

 Dr Haeusler said: "Until now we couldn’t differentiate between the lower risk and the higher risk kids – we’ve treated them all the same. AUS-rule allows lower risk kids to be treated in the comfort of their own home.”

 The study was funded by a National Health and Medical Research Council Grant 

 

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