title: Increase in interleukin-6 serum level preceding fever in granulocytopenia and correlation with death from sepsis.
abstract: Serum interleukin (IL)-6 levels measured by ELISA were correlated with the clinical course of 53 adults with hematologic malignancies in 95 episodes of chemotherapy-induced leukocytopenia (< 1000/microL). The median IL-6 level was 15 pg/mL (range, < 3-123) in 27 episodes without fever. This level was 14.5 pg/mL (range, < 3-187) 72-48 h before onset of fever, 78 pg/mL (range, < 3-170) 24 h before fever in episodes with unexplained fever (FUO), and 182 pg/mL (range, 63-1076) 24 h before fever in episodes with positive blood cultures (P < .001). Within 24 h after onset of fever, median IL-6 level was 171 pg/mL (range, 53-1134) in episodes of FUO, 444 pg/mL (range, 38-7973) in episodes with gram-negative bacteremia, and 2017 pg/mL (range, 76-7253) with gram-positive bacteremia (P < .01). IL-6 levels increased before death in all 13 patients who died of sepsis. Median level was 7253 pg/mL (range, 445-95,906) within 3 days of death. Determination of IL-6 may be useful for early assessment and as a prognostic tool in leukocytopenic fever.
authors.affiliation: Department of Internal Medicine, University of Cologne, Germany.
authors.forename: H T
authors.initials: HT
authors.lastname: Steinmetz
authors.forename: A
authors.initials: A
authors.lastname: Herbertz
authors.forename: M
authors.initials: M
authors.lastname: Bertram
authors.forename: V
authors.initials: V
authors.lastname: Diehl
mesh_terms: D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000139:chemically induced / Q000150:complications* / Q000276:immunology; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005334:Fever / Q000209:etiology*; D005335:Fever of Unknown Origin / Q000209:etiology*; D006689:Hodgkin Disease / Q000188:drug therapy; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007938:Leukemia / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008875:Middle Aged; D011379:Prognosis; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality*
chemical_list: D000970:Antineoplastic Agents; D015850:Interleukin-6