ABSTRACT
It has been shown that Fas, Fas-L, TNF and TNFR-1 display high serum concentrations in subjects with sepsis. This suggests that these are potential severity markers. However, the serum concentration of these molecules in children with leukemia and suspected sepsis has to be established before proposing their use as diagnostic biomarkers. We included children <17 years of age diagnosed with acute lymphoblastic leukemia with neutropenia and fever (NF). The subjects were divided into two groups: (1) leukemia and NF with sepsis, (2) leukemia and NF without sepsis. Determination of serum levels of TNF-α, TNFR-1, Fas and Fas-L was performed using ELISA tests, and apoptosis percentage using flow cytometry. Seventy-two subjects with ALL and NF were included in the two groups. The highest serum levels of TNF-α (35.2 ± 7.6 pg/ml) and TNF-R1 (4102 ± 2440) and the lowest levels of Fas-L (19.4 ± 7.3 pg/ml) were found in group 2: however, the difference in comparison with patients without sepsis was not statistically significant. Low levels of Fas-L and low percentage of apoptotic cells are observed in septic subjects. This pattern may reflect the presence of sepsis among subjects with NF secondary to leukemia.
Subject(s)
Fas Ligand Protein/blood , Fever/etiology , Neutropenia/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Receptors, Tumor Necrosis Factor, Type I/blood , Sepsis/diagnosis , Sepsis/etiology , Tumor Necrosis Factor-alpha/blood , fas Receptor/blood , Adolescent , Biomarkers/blood , Child , Female , Humans , Male , Prospective Studies , Severity of Illness IndexABSTRACT
Among cancer and septic patients, there is a deregulation of common events such as inflammation. This fact limits the use of biomarkers to diagnose sepsis. Through a search in the PubMed database, we identified the clinical studies that evaluated procalcitonin as a biomarker among children with cancer and sepsis; we analyzed its characteristics, advantages and disadvantages. Most of the studies suggest that with a cut-off point between 0.5 ng/dl and 1 mg/dl, procalcitonin displays a sensitivity of 59-78%, a specificity of 76%, a predictive value of 93% and a negative predictive value of 45% to diagnose sepsis. The procalcitonin values were not modified by the use of chemotherapy or steroids. In the past few years, encouraging results have been obtained when using it as a biomarker in children with cancer, particularly with neutropenia and fever.
Subject(s)
Calcitonin/blood , Sepsis/blood , Sepsis/diagnosis , Biomarkers/blood , Child , Fever/complications , Humans , Neoplasms/complications , Neutropenia/complications , Protein Precursors , Sepsis/complicationsABSTRACT
En los enfermos de cáncer, al igual que en los sujetos sépticos, existe desregulación de eventos comunes, como la inflamación, lo que limita el uso de biomarcadores para diagnosticarles sepsis. Mediante una búsqueda en la base de datos PubMed, identificamos los estudios clínicos que evaluaron la procalcitonina como biomarcador en niños con cáncer y sepsis, y analizamos sus características, ventajas y desventajas. La mayoría de los estudios sugieren que, con un punto de corte de 0,5 ng/dl a 1 mg/dl, la procalcitonina presenta una sensibilidad de 59-78%, especificidad de 76%, valor predictivo positivo de 93% y valor predictivo negativo de 45% para el diagnóstico de sepsis. Los valores de procalcitonina no se modifican con el uso de la quimioterapia o el uso de esteroides y, en los últimos años, se han obtenido resultados alentadores en su uso como biomarcador en el niño con cáncer y, particularmente, con neutropenia y fiebre.(AU)
Among cancer and septic patients, there is a deregulation of common events such as inflammation. This fact limits the use of biomarkers to diagnose sepsis. Through a search in the PubMed database, we identified the clinical studies that evaluated procalcitonin as a biomarker among children with cancer and sepsis; we analyzed its characteristics, advantages and disadvantages. Most of the studies suggest that with a cut-off point between 0.5 ng/dl and 1 mg/dl, procalcitonin displays a sensitivity of 59-78%, a specificity of 76%, a predictive value of 93% and a negative predictive value of 45% to diagnose sepsis. The procalcitonin values were not modified by the use of chemotherapy or steroids. In the past few years, encouraging results have been obtained when using it as a biomarker in children with cancer, particularly with neutropenia and fever.(AU)
ABSTRACT
En los enfermos de cáncer, al igual que en los sujetos sépticos, existe desregulación de eventos comunes, como la inflamación, lo que limita el uso de biomarcadores para diagnosticarles sepsis. Mediante una búsqueda en la base de datos PubMed, identificamos los estudios clínicos que evaluaron la procalcitonina como biomarcador en niños con cáncer y sepsis, y analizamos sus características, ventajas y desventajas. La mayoría de los estudios sugieren que, con un punto de corte de 0,5 ng/dl a 1 mg/dl, la procalcitonina presenta una sensibilidad de 59-78%, especificidad de 76%, valor predictivo positivo de 93% y valor predictivo negativo de 45% para el diagnóstico de sepsis. Los valores de procalcitonina no se modifican con el uso de la quimioterapia o el uso de esteroides y, en los últimos años, se han obtenido resultados alentadores en su uso como biomarcador en el niño con cáncer y, particularmente, con neutropenia y fiebre.
Among cancer and septic patients, there is a deregulation of common events such as inflammation. This fact limits the use of biomarkers to diagnose sepsis. Through a search in the PubMed database, we identified the clinical studies that evaluated procalcitonin as a biomarker among children with cancer and sepsis; we analyzed its characteristics, advantages and disadvantages. Most of the studies suggest that with a cut-off point between 0.5 ng/dl and 1 mg/dl, procalcitonin displays a sensitivity of 59-78%, a specificity of 76%, a predictive value of 93% and a negative predictive value of 45% to diagnose sepsis. The procalcitonin values were not modified by the use of chemotherapy or steroids. In the past few years, encouraging results have been obtained when using it as a biomarker in children with cancer, particularly with neutropenia and fever.
Subject(s)
Child , Pediatrics , Biomarkers , Sepsis , Febrile Neutropenia , NeoplasmsABSTRACT
En los enfermos de cáncer, al igual que en los sujetos sépticos, existe desregulación de eventos comunes, como la inflamación, lo que limita el uso de biomarcadores para diagnosticarles sepsis. Mediante una búsqueda en la base de datos PubMed, identificamos los estudios clínicos que evaluaron la procalcitonina como biomarcador en niños con cáncer y sepsis, y analizamos sus características, ventajas y desventajas. La mayoría de los estudios sugieren que, con un punto de corte de 0,5 ng/dl a 1 mg/dl, la procalcitonina presenta una sensibilidad de 59-78%, especificidad de 76%, valor predictivo positivo de 93% y valor predictivo negativo de 45% para el diagnóstico de sepsis. Los valores de procalcitonina no se modifican con el uso de la quimioterapia o el uso de esteroides y, en los últimos años, se han obtenido resultados alentadores en su uso como biomarcador en el niño con cáncer y, particularmente, con neutropenia y fiebre.(AU)
Among cancer and septic patients, there is a deregulation of common events such as inflammation. This fact limits the use of biomarkers to diagnose sepsis. Through a search in the PubMed database, we identified the clinical studies that evaluated procalcitonin as a biomarker among children with cancer and sepsis; we analyzed its characteristics, advantages and disadvantages. Most of the studies suggest that with a cut-off point between 0.5 ng/dl and 1 mg/dl, procalcitonin displays a sensitivity of 59-78%, a specificity of 76%, a predictive value of 93% and a negative predictive value of 45% to diagnose sepsis. The procalcitonin values were not modified by the use of chemotherapy or steroids. In the past few years, encouraging results have been obtained when using it as a biomarker in children with cancer, particularly with neutropenia and fever.(AU)
ABSTRACT
Among cancer and septic patients, there is a deregulation of common events such as inflammation. This fact limits the use of biomarkers to diagnose sepsis. Through a search in the PubMed database, we identified the clinical studies that evaluated procalcitonin as a biomarker among children with cancer and sepsis; we analyzed its characteristics, advantages and disadvantages. Most of the studies suggest that with a cut-off point between 0.5 ng/dl and 1 mg/dl, procalcitonin displays a sensitivity of 59-78
, a specificity of 76
, a predictive value of 93
and a negative predictive value of 45
to diagnose sepsis. The procalcitonin values were not modified by the use of chemotherapy or steroids. In the past few years, encouraging results have been obtained when using it as a biomarker in children with cancer, particularly with neutropenia and fever.