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Viral metagenomics in pediatric oncology patients presenting febrile neutropenia without etiologic diagnosis

Grant number: 22/10278-5
Support Opportunities:Scholarships in Brazil - Master
Effective date (Start): September 01, 2022
Effective date (End): July 31, 2024
Field of knowledge:Biological Sciences - Genetics - Molecular Genetics and Genetics of Microorganisms
Principal Investigator:Svetoslav Nanev Slavov
Grantee:Anielly Sarana da Silva
Host Institution: Hemocentro de Ribeirão Preto. Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP (HCMRP). Secretaria da Saúde (São Paulo - Estado). Ribeirão Preto , SP, Brazil
Associated research grant:17/23205-8 - Evaluation of the impact of emerging and reemerging viruses in the field of hemotherapy and stem cell transplantation by multiple-research approach, AP.JP


Viral metagenomics is one of the most powerful tools for characterizing emerging orunsuspected infections in patients with an unconfirmed diagnosis. Using metagenomics,multiple viral agents have been identified so far, some with high pathogenic potential, thusenabling early clinical intervention and adequate treatment of affected patients. Febrileneutropenia is one of the most frequent life-threatening complications in cancer patientsundergoing oncologic treatment: the adequate management is of paramount importance forthe survival of these patients. As neutropenia is a clinical emergency, treatment is empiricalwith broad-spectrum antibiotics, and in fact, their application has dramatically increasedsurvival rates. It is believed that in most cases the causative agent of neutropenia is bacteria,however, the bacterial pathogen is isolated in culture in only one third of all cases. In order toevaluate possible viral causes for febrile neutropenia, the objective of this project is to applyviral metagenomics in patients with oncological diseases undergoing treatment and withclinical diagnosis of febrile neutropenia. Blood and oropharyngeal swab samples will becollected from 40 pediatric patients with oncological diseases and febrile neutropenia fromthe pediatric oncological diseases outpatient clinic of the Hospital das Clínicas, Faculty ofMedicine of Ribeirão Preto, University of São Paulo. As control we will use a group formedby 40 pediatric patients with oncological diseases in remission who are sporadically returningto the hospital for follow-up. In this project, we will try to identify possible viral causes ofneutropenia in pediatric cancer patients. This would have a significant clinical impact as it canshape the treatment procedures for these patients and detail the virome present in thisemergency clinical condition.

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