Document Detail


Neutrophil regeneration precedes healing of tissue destruction, as indicated by serum C-reactive protein, in children with cancer recovering from neutropenic fever.
MedLine Citation:
PMID:  12222715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the relationship between absolute neutrophil count and C-reactive protein (CRP) in the recovery phase of neutropenic fever among paediatric patients with cancer. METHODS: A total of 102 paediatric oncology patients with 177 episodes of fever and neutropenia was studied prospectively in a two-centre setting. Antimicrobial therapy was discontinued 9 d (mean) post-initiation with a mean absolute neutrophil count of 1.8 x 10(9) l(-1) and CRP of 32 mg l(-1). RESULTS: The mean level of CRP below 20 mg l(-1) was reached on day 12. The level of CRP peaked on the day following the commencement of antimicrobial therapy. Throughout the episodes of fever and neutropenia higher levels of CRP were associated with a lower absolute neutrophil count. Following defervescence the pace of marrow recovery as evidenced by an increasing absolute neutrophil count to > 0.2 and > 0.5 x 10(9) l(-1) was more rapid than the normalization of serum CRP. There was a 2-3 d lag period between absolute neutrophil count exceeding the level of 200 x 10(6) l(-1) and the return of CRP to a baseline level. All episodes were treated successfully and there were no fatalities. CONCLUSION: Among patients recovering from neutropenia and fever the signs of marrow recovery remain the key criterion in evaluating the safety of discontinuing antimicrobial therapy, with serum CRP remaining more of an indicator of ongoing tissue repair.
Authors:
K Vettenranta; L Hovi; A Mäkipernaa; H Jalanko; U M Saarinen-Pihkala
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  91     ISSN:  0803-5253     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2002  
Date Detail:
Created Date:  2002-09-11     Completed Date:  2003-01-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  915-9     Citation Subset:  IM    
Affiliation:
Hospital for Children and Adolescents, University of Helsinki, Finland. kim.vettenranta@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antineoplastic Agents / adverse effects
C-Reactive Protein / analysis*
Child
Child, Preschool
Female
Fever / blood*,  chemically induced,  immunology*
Humans
Infant
Leukocyte Count
Male
Neoplasms / drug therapy,  immunology*
Neutropenia / blood*,  chemically induced,  immunology*
Neutrophils / immunology*
Predictive Value of Tests
Prospective Studies
Regeneration / immunology*
Wound Healing / immunology*
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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