Association between serum levels of MASP-2 and neutropenic febrile attacks in children with leukemia

ABSTRACT

Infectious complications are a major etiology of morbidity and mortality in febrile neutropenic patients. Low serum man-nose-binding lectin [MBL]-associated serine protease-2 [MASP-2] concentration may represent a risk factor for infection in leukemia patients receiving chemotherapy. This study evaluates the relationship between serum levels of MASP-2 with neutropenic febrile attacks in children with leukemia. This prospective cohort study conducted between 2009-2010, we measured baseline serum MASP-2 levels by enzyme-linked immunosorbent assay [ELISA] prior to chemotherapy in leukemia patients less than 14 years of age. The relationship of febrile neutropenia [FN] episodes and duration of hospitalization with MASP-2 concentration was analyzed. We evaluated 75 children [38 girls [51%], 37 boys [49%]; mean age, 61.6 +/- 43.7 months]. There were 8 [10.7%] children with MASP-2 deficiency [< 200 ng/mL]. Mean MASP-2 was 673.2 +/- 288.7 ng/mL [range 116-1112]. Eight patients had no FN episodes. Of the 129 FN episodes recorded, 19 [average 2.4 times] were from the MASP-2deficient group and 110 [average 1.6 times] were in the normal group. There was a significant difference between the mean MASP-2 concentration and FN episodes [P = 0.043]. There was an inverse relationship between FN episodes [r = -0.332, P = 0.004] and the duration of hospitalization [r = -0.334, P= 0.005] with MASP-2 concentration. MASP-2 deficient patients were hospitalized longer than the normal group, which was strongly significant [P < 0.001]. Our study confirmed the results of several previous studies. MASP-2 deficiency in leukemic children treated with chemotherapy was associated with an increased risk of FN episodes, prolonged cumulative duration of hospitalization, and intravenous antimicrobial therapy