Current Oncology

Background: Febrile neutropenia is a critical emergency construct, but infection and sepsis can occur without fever. Objective: To examine the clinical evidence of nonfebrile neutropenic infection, potential mechanisms of an attenuated febrile response, physiological body-temperature variation, and limitations of clinical thermometry. Methods: A narrative review was supplemented by a targeted, transparently documented three-domain evidence map of published systematic syntheses, thermometry-accuracy studies, and oncology-neutropenia cohorts, updated on 1 November 2026. No new exhaustive systematic review or meta-analysis was performed. Results: A synthesis of 36 studies (7636 healthy adults) reported site-specific oral and rectal temperature distributions of 35.73–37.41 °C and 36.32–37.76 °C (mean ± 2 SD), which do not establish a universal core-temperature interval. Peripheral and oral thermometers demonstrated pooled fever-detection sensitivities of 0.64 and 0.53, respectively, in non-neutropenia-specific populations. Nonfebrile infection proportions included 9/69 (13.0%) severe ICU infection episodes and 70/186 (37.6%) bloodstream infections without a recorded temperature ≥ 38.0 °C in a separate oncology-neutropenia cohort; an additional post-transplant corticosteroid cohort is discussed separately. These denominators do not permit a meaningful pooled incidence of afebrile neutropenic sepsis. Conclusions: Fever-based clinical pathways remain essential, but suspected infection, physiological deterioration, and organ dysfunction warrant evaluation irrespective of temperature.

Background: Hope is an important psychological resource in patients with hematologic malignancies, but how family functioning is associated with hope remains unclear. Methods: We retrospectively analyzed routine psychometric data from 226 hospitalized adults with hematologic malignancies assessed between June 2022 and December 2025 (39 patients [17.3%] had ≤10% missing items, imputed using individual scale means). Measures included the Herth Hope Index, Meaning in Life Questionnaire, Medical Coping Modes Questionnaire, and Family Adaptability and Cohesion Evaluation Scale. Correlation, multivariable linear regression, exploratory logistic regression, and an exploratory bootstrap decomposition of parallel indirect associations were performed. Results: Mean hope was slightly below an oncology reference value (difference −1.22 points; p < 0.001), a difference in uncertain clinical relevance; family cohesion and facing coping scores were below normative values, whereas resignation and avoidance were higher (all p < 0.001). Hope correlated positively with presence of meaning (r = 0.595), facing (r = 0.510), and family cohesion (r = 0.444), and negatively with resignation (r = −0.611). In multivariable linear regression, presence of meaning, search for meaning, facing, resignation, family cohesion, family adaptability, education, and ECOG performance status were associated with hope (R² = 0.653). Family cohesion showed a total association with hope of 0.209; the combined indirect association through facing, resignation, and presence of meaning was 0.111 (53.04% of the total association in the statistical decomposition). Conclusions: Family cohesion, coping style, and meaning in life are closely associated with hope in hematologic malignancies. Because of the cross-sectional design, these findings cannot establish causal direction; they support routine assessment of family functioning and the testing of family-based interventions in future prospective studies.

Introduction: Totally implantable venous access ports are widely regarded as reliable vascular access devices; however, they are often associated with complications including thrombotic occlusion, catheter tip misplacement, device fracture and infection. Among these, catheter-related bloodstream infections (CRBSIs) represent a particularly severe complication in oncological patients, especially during cytotoxic chemotherapy. Although seasonal variation in infectious complications has repeatedly been suggested in the literature, its impact on CRBSIs remains insufficiently investigated. Methods: We retrospectively analyzed a cohort of 1773 oncology patients with documented port-related procedures, of whom 795 underwent port explantation between 2010 and 2017 at the Department of Hematology and Oncology of the Kepler University Hospital in Linz, Austria. Port explantations were categorized according to season, with June, July, and August defined as the warm season and the remaining months as the cold season. CRBSI occurrence was analyzed with regard to seasonality and potential clinical risk factors. Results: Among the 795 port explantations, 98 CRBSIs were identified (12.33%). The proportion of CRBSIs was significantly higher during the warm season than during the cold season (18.75% vs. 10.50%; p = 0.006). Logistic regression analysis identified warm season as significantly associated with CRBSI, with an odds ratio of 1.740 (95% CI: 1.058–2.862; p = 0.0291). Discussion: CRBSIs were significantly more frequent among port explantations performed during the warm season. These findings demonstrate a significant association between the warm season and CRBSI occurrence among patients undergoing port explantation and may support increased clinical awareness and surveillance during warmer months.