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Clin Invest Med ; 30(2): E75-85, 2007.
Article in English | MEDLINE | ID: mdl-17716545

ABSTRACT

PURPOSE: Procalcitonin has proven to be a sensitive inflammatory marker in non-neutropenic patients. The aim of this study was to determine and compare Procalcitonin with other inflammatory markers in the serum of immunosuppressed children with haematological malignancies; and to assess the predictive value of these mediators in distinguishing between bacterial and non-bacterial infection. METHODS & RESULTS: The study included 37 children with acute lymphoblastic leukaemia undergoing intensive chemotherapy. They were divided into 3 groups, A, B and C. Group A consisted of 29 neutropenic children with 94 febrile episodes, group B of 20 neutropenic children with 56 afebrile episodes and group C of 13 non-neutropenic children with 58 afebrile episodes. Serial serum levels of PCT, C-Reactive Protein, Neopterin, Interleukin-6 and NO2/NO3 were all determined on a day-to-day basis for 7 consecutive days. In serum the concentrations of CRP was determined by nephelometry, of PCT by immunoluminescence and of Neopterin, IL-6 and NO2/NO3 by ELISA method. CONCLUSIONS: According to our results the Procalcitonin concentration increased rapidly in patients with microbial infection; the response was detectable within 24 hs of the onset of fever due to microbial infections. Procalcitonin is a specific and sensitive marker of microbial infection in patients with neutropenic fever. The markers, C-Reactive Protein, Interleukin-6 and NO2/NO3 may not help to identify infections and distinguish the etiology of infection in neutropenic febrile children with acute lymphoblastic leukaemia.


Subject(s)
Bacterial Infections/blood , Calcitonin/blood , Immune Tolerance/drug effects , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Protein Precursors/blood , Adolescent , Bacterial Infections/diagnosis , Bacterial Infections/etiology , C-Reactive Protein/metabolism , Calcitonin Gene-Related Peptide , Child , Child, Preschool , Drug Therapy/methods , Drug-Related Side Effects and Adverse Reactions , Enzyme-Linked Immunosorbent Assay , Humans , Immune Tolerance/immunology , Infant , Interleukin-6/blood , Neopterin/blood , Nephelometry and Turbidimetry , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Predictive Value of Tests
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