Outpatient management of FN cases that are deemed to be low risk with oral or IV antibiotics might well be effective in children with cancer, but clinical trials have not yet established the safety of this approach as an alternative to traditional inpatient IV antibiotic therapy.1 Furthermore, risk stratification for children with cancer and FN remains a significant empirical challenge; while prediction tools for adverse outcomes are under development, no risk stratification system has yet been validated or widely adopted for clinical use with children.4-7 The popular Multinational Association for Supportive Care in Cancer [MASCC] risk index, for example, is not used with children.5,8