Endotoxin, interleukin-6 and phospholipase-A2 as markers of sepsis in patients with hematological malignancies.
The concentrations of endotoxin, interleukin-6 (IL-6) and group II phospholipase-A2 (PLA2-II) were measured in serum or plasma during cytotoxic chemotherapy, fever of unknown origin and sepsis in 56 patients with hematological malignancies and during sepsis and viral infections in 22 non-hematological patients. High concentrations of IL-6, PLA2-II and endotoxin were detected in sepsis, the levels being similarly elevated in hematological and non-hematological patients. The levels of IL-6 and PLA2-II correlated closely with that of C-reactive protein (CRP). The levels of PLA2-II and IL-6 declined earlier than the level of CRP during the course of antimicrobial treatment. The levels of IL-6 also rose earlier than the level of CRP. The ability of IL-6 and PLA2-II and endotoxin to discriminate between sepsis and other causes of fever was comparable to that of CRP. IL-6 and PLA2-II are, together with CRP, valuable tools for the detection of sepsis in patients with hematological malignancies who undergo cytotoxic medication. Endotoxin is not suitable for routine laboratory diagnosis of sepsis.
Rintala
E
E
Department of Medicine, University of Turku, Finland.
Pulkki
K
K
Mertsola
J
J
Nevalainen
T
T
Nikoskelainen
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000741:Anemia, Aplastic / Q000188:drug therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D015415:Biomarkers; D001769:Blood / Q000382:microbiology; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D004731:Endotoxins / Q000097:blood*; D005069:Evaluation Studies as Topic; D005260:Female; D006402:Hematologic Diseases / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood*; D007938:Leukemia / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D008232:Lymphoproliferative Disorders / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D010741:Phospholipases A / Q000097:blood*; D054467:Phospholipases A2; D018805:Sepsis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014777:Virus Diseases / Q000097:blood
D000900:Anti-Bacterial Agents; D000970:Antineoplastic Agents; D015415:Biomarkers; D004731:Endotoxins; D015850:Interleukin-6; D002097:C-Reactive Protein; D010741:Phospholipases A; D054467:Phospholipases A2