title: Elevation of soluble tumor necrosis factor receptor II in non-febrile patients with acute myeloid leukemia.
abstract: BACKGROUND
  Tumor necrosis factor alpha (TNF) and its cellular and soluble (s) receptors (TNF-R) are important mediators in acute myeloid leukemia (AML) and infectious complications during cytoreductive therapy. We investigated the serum concentrations of sTNF-RII in previously untreated patients with AML at the onset of cytoreductive therapy and in non-febrile chemotherapy-associated neutropenia.
  
  
  METHODS
  Of 54 eligible patients with AML, serum concentrations of sTNF-RII could be evaluated in 25 non-neutropenic, non-febrile and in 11 neutropenic, non-febrile patients.
  
  
  RESULTS
  At baseline, non-neutropenic, non-febrile AML patients showed high median serum sTNF-RII concentrations of 3,804 pg/mL. In neutropenia, there was a non-significant trend (p = 0.18) to lower median sTNF-RII levels of 3,246 pg/mL.
  
  
  CONCLUSIONS
  Serum sTNF-RII concentrations in non-febrile AML patients before chemotherapy are in the range of levels reached in uncomplicated febrile episodes in otherwise healthy individuals. This must be taken into account when evaluating the cytokine profile for sepsis in patients with therapy-associated neutropenia. Concentrations are still elevated in neutropenia, suggesting that a normal number of leukocytes is not necessarily required for the activation of the TNF ligand/TNF receptor system in AML.
authors.affiliation: Medizinische Klinik, Universität Mainz, München, Germany. mgoetz@mail.uni-mainz.de
authors.forename: M
authors.initials: M
authors.lastname: Goetz
authors.forename: X
authors.initials: X
authors.lastname: Schiel
authors.forename: H
authors.initials: H
authors.lastname: Heussel
authors.forename: T
authors.initials: T
authors.lastname: Steinmetz
authors.forename: W
authors.initials: W
authors.lastname: Hiddemann
authors.forename: M
authors.initials: M
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000368:Aged; D000616:Aminoglutethimide / Q000008:administration & dosage / Q000009:adverse effects; D015703:Antigens, CD / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects; D003613:Danazol / Q000008:administration & dosage / Q000009:adverse effects; D000068800:Etanercept; D005260:Female; D005334:Fever; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D015470:Leukemia, Myeloid, Acute / Q000097:blood* / Q000188:drug therapy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood / Q000139:chemically induced; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood*; D047889:Receptors, Tumor Necrosis Factor, Type II; D013629:Tamoxifen / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D015703:Antigens, CD; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D047889:Receptors, Tumor Necrosis Factor, Type II; D013629:Tamoxifen; D000616:Aminoglutethimide; D003613:Danazol; D000068800:Etanercept