| Biomarkers for risk stratification of febrile neutropenia among children with malignancy: a pilot study. | |
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MedLine Citation:
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PMID: 22535591 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients receiving myelosuppressive chemotherapy remain at increased risk for developing febrile neutropenia (FN). For this heterogeneous population, a biomarker based risk stratification of FN patients may be a useful clinical tool. We hypothesized that serum biomarkers during initial presentation of an FN event could be predictive of subsequent clinical outcome. PROCEDURE: Eighty-nine FN events from 36 non-consecutive subjects were analyzed. "High-risk" FN criteria included prolonged hospitalization (≥ 7 days), admission to pediatric intensive care unit (PICU) or a microbiology confirmed bacteremia. Patients with "low risk" FN had none of the above. Biomarkers measured during the first 2 days of FN hospitalization were analyzed and correlated with respective clinical outcome. RESULTS: Of the 89 FN events, 44 (49%) fulfilled pre-defined high-risk criteria and 45 (51%) were low-risk. Procalcitonin level (>0.11 ng/ml) was found to be associated with the high-risk FN outcome with sensitivity of 97%. With an increase in log scale by 1, the odds of being high-risk FN increased twofold. Hs-CRP >100 mg/L had sensitivity of 88% in predicting high-risk FN. The odds of a high-risk FN event increased by approximately 1.8-fold with an increase in the log scale of hs-CRP by 1 (10-fold). In univariate analysis, IL-6, IL-8, and IL-10 were statistically significant and associated with high-risk FN. However, no statistically significant difference was found for IL-1α, sIL-2Ra, IL-3, or TNF-α. CONCLUSIONS: Biomarkers with appropriate critical threshold values may be a useful clinical tool for appropriate risk stratification of children with FN. |
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Authors:
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Amir Mian; David Becton; Robert Saylors; Laura James; Xinyu Tang; Adnan Bhutta; Parthak Prodhan |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2012-04-25 |
Journal Detail:
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Title: Pediatric blood & cancer Volume: 59 ISSN: 1545-5017 ISO Abbreviation: Pediatr Blood Cancer Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-06-12 Completed Date: 2012-09-17 Revised Date: 2013-01-18 |
Medline Journal Info:
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Nlm Unique ID: 101186624 Medline TA: Pediatr Blood Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 238-45 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Wiley Periodicals, Inc. |
Affiliation:
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Department of Pediatric Hematology-Oncology, College of Medicine, University of Arkansas Medical Sciences, Arkansas Children's Hospital, Little Rock, Arkansas 72205, USA. mianamir@uams.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Biological Markers / analysis* Calcitonin / blood Child Child, Preschool Female Hospitalization Humans Infant Intensive Care Units Interleukin-10 / blood Interleukin-3 / blood Interleukin-6 / blood Interleukin-8 / blood Male Neoplasms / complications*, drug therapy Neutropenia / drug therapy, etiology* Pilot Projects Prognosis Prospective Studies Protein Precursors / blood ROC Curve Risk Factors Tumor Necrosis Factor-alpha / blood Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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UL1 TR000077/TR/NCATS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Interleukin-3; 0/Interleukin-6; 0/Interleukin-8; 0/Protein Precursors; 0/Tumor Necrosis Factor-alpha; 130068-27-8/Interleukin-10; 56645-65-9/procalcitonin; 9007-12-9/Calcitonin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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