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Suspected Neutropenic FeverDUCATIS - S1NCT07901660

Diagnostic Accuracy, Clinical Utility and Implementation of Point-of-Care Absolute Neutrophil Count in Suspected Neutropenic Fever (DUCATIS) - Diagnostic Accuracy (S1)

A study testing Hemocue® WBC DIFF system in people with Suspected Neutropenic Fever and Confirmed Neutropenic Fever, run by The University of Hong Kong at 1 site in Hong Kong.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

Study 1 (S1). In a range of adult patients with sNF and controls, there is no significant difference between the POC-ANC and laboratory analyser. The diagnostic study will be performed 24 hours a day. Informed consent will be sought from every patient for a finger prick (capillary blood) and venous blood sample. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Hemocue® WBC DIFF system
Could I receive a placebo?
No, everyone receives an active treatment
How many people
317 participants
Where
1 siteHong Kong
Study dates
1 Jan 2027to 31 Mar 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥18 years; AND
  • Suspected low ANC; AND
  • Stable.

Who cannot join

  • No consent obtained
  • Blood sampling my hinder the management of the patient according to the doctor or nurse.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Timothy Rainer contact

+852 39176846

thrainer@hku.hk

Manson Yeung contact

+852 39103191

htmanson@hku.hk

Hong Kong1 site
  • Queen Mary Hospital

    Hong Kong

    Timothy Rainer, 39176846, thrainer@hku.hk

Other trials in Hong Kong

About this study

Study 1 (S1). In a range of adult patients with sNF and controls, there is no significant difference between the POC-ANC and laboratory analyser.

The diagnostic study will be performed 24 hours a day. Informed consent will be sought from every patient for a finger prick (capillary blood) and venous blood sample.

Briefly, paired capillary (finger prick) and venous EDTA blood samples will be obtained from 317 patients meeting the inclusion criteria.

Prospective diagnostic accuracy study. The target accuracy index is the lower 95%CI of sensitivity, although we evaluate other important factors of diagnostic accuracy (see data analysis below).

Read the detailed description

Questions

In ED and hospitalised adult cancer patients with sNF, is a POC-ANC sufficiently accurate as a diagnostic test compared with a laboratory gold standard?

Primary hypotheses

Study 1 (S1). In a range of adult patients with sNF and controls, there is no significant difference between the POC-ANC and laboratory analyser.

Definitions

Suspected neutropenic fever (sNF) refers to fever after myelosuppressive cancer treatment in a patient in whom neutropenia is suspected, before laboratory confirmation.

The definition of NF varies across different international guidelines. In this proposal, NF is defined as an ANC <1.0 × 10⁹/L and fever with a single oral temperature of ≥38.3°C (101°F) or a temperature of ≥38.0°C (100.4°F) sustained over a one-hour period after myelosuppressive cancer treatment in the ED or within 24 hours prior to ED registration. However, some guidelines and oncologists set the definition of NF at <0.5 × 10⁹/L.

Severe neutropenia is defined as an ANC <0.5 × 10⁹/L. This NF definition leaves a safety margin with an anticipation that some patients with an initial ANC of 0.5-1.0 × 10⁹/L may progress to severe neutropenia over the next 48 hours.

Thus, sNF patients will be further categorised into severe NF (ANC <0.5 × 10⁹/L), non-severe NF (ANC 0.5-1.0 × 10⁹/L) and non-NF (ANC ≥1.0 × 10⁹/L) for comparison.

S1. Diagnostic Accuracy

The diagnostic study will be performed 24 hours a day. Informed consent will be sought from every patient for a finger prick (capillary blood) and venous blood sample.

We use methods as previously reported by Russcher [16]. Briefly, paired capillary (finger prick) and venous EDTA blood samples will be obtained from 317 patients meeting the inclusion criteria. Reference counts (Gold standard) will be obtained by a standardised Sysmex XE-5000 automated cell counter (Sysmex Corporation, Kobe, Japan). All samples will be analysed in duplicates on the HemoCue WBC DIFF system and in single replicate on the Sysmex XE-5000 within 8 hours after collection. The timespan between analyses on both systems should be less than 2 hours for each sample.

Justification for evaluating capillary blood

It is important to evaluate the accuracy of capillary blood as the POCANC device might find a use in other settings e.g. clinics, or home use.

Outcomes

Prospective diagnostic accuracy study. The target accuracy index is the lower 95%CI of sensitivity, although we evaluate other important factors of diagnostic accuracy (see data analysis below).

Data processing

The primary analysis is on sensitivity of 97 - 99.9% looking to safely rule out NF.

In addition we will evaluate accuracy of the ANC aiming for the slope for linear regression between both test and reference methods no more than ± 5% (r≥0.95).

We will also calculate pooled standard deviations (SD) and coefficient variations (CV). We will report the SD/CV and Bland-Altman Limits of acceptance (LoA) aiming for <15%. All the data will be analysed using orthogonal regression analysis (Deming regression) and Pearson's correlation coefficient (r).

We will also report intra-and inter-class variation, inter-hospital laboratory variation (where available), specificity, AUC, NPV and PPV.

Missing Data

Patients with missing laboratory or POCT ANC data will be excluded from data analysis. For POCT ANC values below lower limit of detection leading to the absence of a numerical value, pairwise correlation analysis will not be performed. Other missing values will not be imputed.

Ethics approval

This study has been approved by the Institutional Review Board of The University of Hong Kong/Hospital Authority Hong Kong West Cluster (HKU/HA HKW IRB; reference number: UW 25-660).

Being tested
Hemocue® WBC DIFF system
Keywords
DUCATIS, neutropenic fever, febrile neutropenia, point-of-care, diagnostic accuracy, neutrophil, absolute neutrophil count, ANC
Medical subject headings
Febrile Neutropenia, Neutropenia, Leukopenia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hemocue® WBC DIFF systemDiagnostic test

    Also called POC-ANC, POCT-ANC

    Briefly, paired capillary (finger prick) and venous EDTA blood samples will be obtained from 317 patients meeting the inclusion criteria. Reference counts (Gold standard) will be obtained by a standardised Sysmex XE-5000 automated cell counter (Sysmex Corporation, Kobe, Japan). All samples will be analysed in duplicates on the HemoCue WBC DIFF system and in single replicate on the Sysmex XE-5000 within 8 hours after collection. The timespan between analyses on both systems should be less than 2 hours for each sample.

Study groups in NCT07901660
Study groupRoleWhat they receive
Consented participantsExperimentalS1. Adult patients with suspected low ANC in the ED or admitted to medical wards. 1. ≥18 years; AND 2. Suspected low ANC; AND 3. Stable
Receives: Diagnostic Test: Hemocue® WBC DIFF system

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. sensitivity of POC-ANC compared with the laboratory reference method

    The target accuracy index is the lower 95%CI of sensitivity, although we evaluate other important factors of diagnostic accuracy (see data analysis below).

    The primary analysis is on sensitivity of 97 - 99.9% looking to safely rule out NF.

    Measured: All samples will be analysed in duplicates on the HemoCue WBC DIFF system and in single replicate on the Sysmex XE-5000 within 8 hours after collection.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Oct 2026
  2. Study start1 Jan 2027 (estimated)
  3. Primary completion31 Dec 2027 (estimated)
  4. Study completion31 Mar 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Not applicable
Intervention model
Single group
Model description
Study Design S1. Prospective diagnostic accuracy of POC-ANC; S1. Diagnostic Accuracy The diagnostic study will be performed 24 hours a day. Informed consent will be sought from every patient for a finger prick (capillary blood) and venous blood sample. We use methods as previously reported by Russcher \[16\]. Briefly, paired capillary (finger prick) and venous EDTA blood samples will be obtained from 317 patients meeting the inclusion criteria. Reference counts (Gold standard) will be obtained by a standard¬ised Sysmex XE-5000 automated cell counter (Sysmex Corporation, Kobe, Japan). All samples will be analysed in duplicates on the HemoCue WBC DIFF system and in single replicate on the Sysmex XE-5000 within 8 hours after collection. The timespan between analyses on both systems should be less than 2 hours for each sample.
Masking
None (open label)
Enrolment
317 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07901660
Sponsor's protocol ID
DUCATIS - S1
Other IDs
HMRF
Acronym
DUCATIS - S1
Status last verified
Oct 2026
First submitted
21 Oct 2026
Last updated
28 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Weycker D, Li X, Edelsberg J, Barron R, Kartashov A, Xu H, Lyman GH. Risk and Consequences of Chemotherapy-Induced Febrile Neutropenia in Patients With Metastatic Solid Tumors. J Oncol Pract. 2015 Jan;11(1):47-54. doi: 10.1200/JOP.2014.001492. Epub 2014 Dec 9.

    PubMed 25491042
  • Culakova E, Thota R, Poniewierski MS, Kuderer NM, Wogu AF, Dale DC, Crawford J, Lyman GH. Patterns of chemotherapy-associated toxicity and supportive care in US oncology practice: a nationwide prospective cohort study. Cancer Med. 2014 Apr;3(2):434-44. doi: 10.1002/cam4.200. Epub 2014 Feb 17.

    PubMed 24706592
  • Klastersky J, Ameye L, Maertens J, Georgala A, Muanza F, Aoun M, Ferrant A, Rapoport B, Rolston K, Paesmans M. Bacteraemia in febrile neutropenic cancer patients. Int J Antimicrob Agents. 2007 Nov;30 Suppl 1:S51-9. doi: 10.1016/j.ijantimicag.2007.06.012. Epub 2007 Aug 8.

    PubMed 17689933
  • Caggiano V, Weiss RV, Rickert TS, Linde-Zwirble WT. Incidence, cost, and mortality of neutropenia hospitalization associated with chemotherapy. Cancer. 2005 May 1;103(9):1916-24. doi: 10.1002/cncr.20983.

    PubMed 15751024
  • Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK, Langston AA, Nastoupil LJ, Rajotte M, Rolston K, Strasfeld L, Flowers CR. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy: American Society of Clinical Oncology and Infectious Diseases Society of America Clinical Practice Guideline Update. J Clin Oncol. 2018 May 10;36(14):1443-1453. doi: 10.1200/JCO.2017.77.6211. Epub 2018 Feb 20.

    PubMed 29461916
  • Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 update. Intensive Care Med. 2018 Jun;44(6):925-928. doi: 10.1007/s00134-018-5085-0. Epub 2018 Apr 19. No abstract available.

    PubMed 29675566
  • Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, Raad II, Rolston KV, Young JA, Wingard JR; Infectious Diseases Society of America. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011 Feb 15;52(4):e56-93. doi: 10.1093/cid/cir073.

    PubMed 21258094
  • Averbuch D, Orasch C, Cordonnier C, Livermore DM, Mikulska M, Viscoli C, Gyssens IC, Kern WV, Klyasova G, Marchetti O, Engelhard D, Akova M; ECIL4, a joint venture of EBMT, EORTC, ICHS, ESGICH/ESCMID and ELN. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: summary of the 2011 4th European Conference on Infections in Leukemia. Haematologica. 2013 Dec;98(12):1826-35. doi: 10.3324/haematol.2013.091025.

    PubMed 24323983
  • Baden LR, Swaminathan S, Angarone M, Blouin G, Camins BC, Casper C, Cooper B, Dubberke ER, Engemann AM, Freifeld AG, Greene JN, Ito JI, Kaul DR, Lustberg ME, Montoya JG, Rolston K, Satyanarayana G, Segal B, Seo SK, Shoham S, Taplitz R, Topal J, Wilson JW, Hoffmann KG, Smith C. Prevention and Treatment of Cancer-Related Infections, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2016 Jul;14(7):882-913. doi: 10.6004/jnccn.2016.0093.

    PubMed 27407129
  • Keck JM, Wingler MJB, Cretella DA, Vijayvargiya P, Wagner JL, Barber KE, Jhaveri TA, Stover KR. Approach to fever in patients with neutropenia: a review of diagnosis and management. Ther Adv Infect Dis. 2022 Nov 26;9:20499361221138346. doi: 10.1177/20499361221138346. eCollection 2022 Jan-Dec.

    PubMed 36451936
  • 11. HemoCue AB. HemoCue WBC DIFF System [Internet]. Ängelholm: HemoCue AB; [date unknown] [cited 2025 Feb 24]. Available from: https://hemocue.com/en/products/hematology/hemocue-wbc-diff-system/

  • Peyrony O, Gerlier C, Barla I, Ellouze S, Legay L, Azoulay E, Chevret S, Fontaine JP. Antibiotic prescribing and outcomes in cancer patients with febrile neutropenia in the emergency department. PLoS One. 2020 Feb 28;15(2):e0229828. doi: 10.1371/journal.pone.0229828. eCollection 2020.

    PubMed 32109264
  • Mettert K, Lewis C, Dorsey C, Halko H, Weiner B. Measuring implementation outcomes: An updated systematic review of measures' psychometric properties. Implement Res Pract. 2020 Aug 28;1:2633489520936644. doi: 10.1177/2633489520936644. eCollection 2020 Jan-Dec.

    PubMed 37089128
  • Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011 Mar;38(2):65-76. doi: 10.1007/s10488-010-0319-7.

    PubMed 20957426
  • Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999 Sep;89(9):1322-7. doi: 10.2105/ajph.89.9.1322.

    PubMed 10474547

Questions about this trial

What is this clinical trial studying?

A study testing Hemocue® WBC DIFF system in people with Suspected Neutropenic Fever and Confirmed Neutropenic Fever, run by The University of Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 28 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Timothy Rainer (+852 39176846, thrainer@hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

sensitivity of POC-ANC compared with the laboratory reference method (time frame: All samples will be analysed in duplicates on the HemoCue WBC DIFF system and in single replicate on the Sysmex XE-5000 within 8 hours after collection.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07901660, which also lists 28 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Oct 2026.

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