无严重中性粒细胞减少（绝对中性粒细胞计数[ANC]≥500/µL）的发热干细胞移植（SCT）患者的最佳管理方法尚不清楚。作者们开发了迭代风险预测模型（Esbenshade Vanderbilt [EsVan] 模型），可可靠地预测无严重中性粒细胞减少的幼儿肿瘤患者中的血流感染（BSI），但SCT特异性数据有限。在一家医疗机构中，识别出2005年5月至2019年11月发生的所有干细胞移植，摘录伴有中心静脉导管和ANC值≥500/µL的发热病例。将所有以前版本的EsVan模型应用于SCT数据，并生成c-统计数据。将模型额外应用于每种移植类型（自体/异体），并开发并内部验证了一种进一步调整免疫抑制度量的异体移植EsVan蒂尔特Van Allogeneic SCT Model (EsVanAlloSCT)。对于429个SCT病例（221个自体和208个异体），BSI发生率为19.6％（429个中的84个），在异体移植患者（25.5％）中高于自体移植患者（14.0％；p <0.01）。EsVan模型的所有版本在整体SCT队列中表现良好（c统计数字为0.759-0.795）。EsVan模型对于自体移植病例的表现要好得多（c统计数字为0.869-0.881），而对于异体移植SCT病例的表现要差得多（c统计数字为0.678-0.717）。添加了免疫抑制程度调整的新的异体移植特异性模型EsVanAlloSCT，在异体移植SCT中产生了0.792的c-统计数据（引导矫正为0.750）。当应用于自体SCT时，EsVan模型的运行情况异常良好，但当应用于异体SCT时工作效果较差。EsVanAlloSCT在异体SCT中似乎能够提高预测能力，但需要进行额外的外部验证。© 2023美国癌症协会。

The optimal management of febrile stem cell transplant (SCT) patients presenting without severe neutropenia (absolute neutrophil count [ANC] ≥ 500/µL) is unclear. The authors have developed iterative risk prediction models (Esbenshade Vanderbilt [EsVan] models) that reliably predict bloodstream infections (BSIs) in the febrile general pediatric oncology population without severe neutropenia, but SCT-specific data are limited.All SCTs occurring from May 2005 to November 2019 at a single institution were identified. Episodes of fever with a central venous catheter and ANC values ≥ 500/µL were abstracted. All previous versions of the EsVan model were applied to the SCT data, and c-statistics were generated. The models were additionally applied to each type of transplant (autologous/allogeneic), and a new allogeneic model that further adjusted for metrics of immunosuppression, Esbenshade Vanderbilt Allogeneic SCT Model (EsVanAlloSCT), was developed and internally validated.For 429 SCT episodes (221 autologous and 208 allogeneic), the BSI incidence was 19.6% (84 of 429), and it was higher in allogeneic transplant patients (25.5%) than autologous transplant patients (14.0%; p < .01). All versions of the EsVan model performed well for the overall SCT cohort (c-statistics, 0.759-0.795). The EsVan models performed better for the autologous episodes (c-statistics, 0.869-0.881) than the allogeneic SCT episodes (c-statistics, 0.678-0.717). The new allogeneic transplant-specific model, EsVanAlloSCT, which added an adjustment for the extent of immunosuppression, yielded a c-statistic of 0.792 (bootstrap-corrected, 0.750).The EsVan models work exceptionally well when they are applied to autologous SCT, but they work less well for allogeneic SCT. EsVanAlloSCT appears to improve the predictive ability in allogeneic SCT, but it will need additional external validation.© 2023 American Cancer Society.