Table 5.7GRADE profile: Is primary prophylaxis with granulocyte infusion more effective than no such prophylaxis at improving outcomes in patients at risk of neutropenic sepsis

Quality assessmentNo of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsProphylaxis with granulocyte infusionNo prophylaxis with granulocyte infusionRelative
(95% CI)		Absolute
Mortality
10randomised trialsserious1no serious inconsistencyno serious indirectnessserious2,3none62/347 (17.9%)64/358 (17.9%)RR 0.94
(0.71 to 1.25)		11 fewer per 1000
(from 52 fewer to 45 more)		LOW
Febrile neutropenia
2randomised trialsserious4serious5no serious indirectnessserious2none46/66 (69.7%)92/109 (84.4%)RR 0.85
(0.69 to 1.05)		127 fewer per 1000
(from 262 fewer to 42 more)		VERY LOW
Antibiotic resistance - not reported
0----------
Length of hospital stay - not reported
0----------
Quality of life - not reported
0----------
1

One trial had adequate allocation concealment, blinding was unclear in all trials

2

Low number of events

3

95% confidence interval around the pooled estimate of effect includes both no effect and appreciable benefit or appreciable harm.

4

Unclear allocation concealment and blinding

5

Unexplained statistically significant heterogeneity

From: 5, Reducing the risk of septic complications of anticancer treatment

Cover of Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients
Neutropenic Sepsis: Prevention and Management of Neutropenic Sepsis in Cancer Patients.
NICE Clinical Guidelines, No. 151.
National Collaborating Centre for Cancer (UK).
Copyright © National Collaborating Centre for Cancer, 2012.

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