Interleukin-5, interleukin-6, interleukin-8 and tumour necrosis factor-alpha levels obtained within 24-h of admission do not predict high-risk infection in children with febrile neutropenia.
Indian J Med Microbiol
;
2013 Jul-Sept; 31(3): 226-229
Artigo
em Inglês
| IMSEAR
| ID: sea-148088
ABSTRACT
Purpose:
Biomarkers that can predict the severity of febrile neutropenia (FN) are potential tools for clinical practice.Objective:
The objective of this study is to evaluate the reliability of plasma interleukin (IL) levels as indicators of high-risk FN. Materials andMethods:
Children with haematological malignancies and FN were enrolled prospectively. A blood sample was obtained within 24-h of admission for estimation of IL-5, IL-6, IL-8 and tumour necrosis factor-alpha (TNF-α) level by the enzyme-linked immunosorbent assay. Patients were stratified into three groups. Group I (low-risk) No focus of infection; Group II Clinical/radiological focus of infection; Group III Microbiologically proven infection or FN related mortality. Groups II and III were analysed as high-risk. The cytokines were assessed at three different cut-off levels.Results:
A total of 52 episodes of FN in 48 patients were evaluated. The mean age was 6 years (range 2-13). Primary diagnosis included acute lymphoblastic leukaemia (82%), non-Hodgkin's lymphoma (13%) and acute myeloid leukaemia (5%). Absolute neutrophil count was < 200 cells/μl in half and 200-500 in 23%. Majority were categorised as Group I (69%), followed by Group II (16%) and III (15%). The range of IL-5 was too narrow and similar in the two risk-groups to be of any relevance. The best sensitivity of TNF-α and IL-6 for high-risk group was 78% and 70%, respectively. The highest specificity observed was 35%. The negative predictive value of IL-6, IL-8 and TNF-α exceeded 80%.Conclusion:
IL-5, IL-6, IL-8 and TNF-α failed as predictors of clinically localised or microbiologically documented infection in children with chemotherapy induced FN. However, IL-6, IL-8 and TNF-α could be useful in excluding the possibility of high-risk infection.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Tipo de estudo:
Estudo de etiologia
/
Estudo prognóstico
Idioma:
Inglês
Revista:
Indian J Med Microbiol
Assunto da revista:
Microbiology
Ano de publicação:
2013
Tipo de documento:
Artigo
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