Document Detail


Biomarkers for risk stratification of febrile neutropenia among children with malignancy: a pilot study.
MedLine Citation:
PMID:  22535591     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Amir Mian; David Becton; Robert Saylors; Laura James; Xinyu Tang; Adnan Bhutta; Parthak Prodhan
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-25
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  59     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-06-12     Completed Date:  2012-09-17     Revised Date:  2013-01-18    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  238-45     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
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
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MeSH Terms
Descriptor/Qualifier:
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:
UL1 TR000077/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
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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