Interleukin-6, interleukin-8, interleukin-10, and C-reactive protein in febrile neutropenia in children with malignant diseases.
OBJECTIVE
To compare serum levels of interleukin-6, interleukin-8 and interleukin-10 in bacteremic and non-bacteremic episodes of febrile neutropenia in children with malignant diseases, and determine their changes and correlation with C-reactive protein (CRP).


METHODS
Between January 2003 and June 2004, we examined 41 episodes of febrile neutropenia in 24 children with malignant diseases who were receiving polychemotherapy. C-reactive protein was measured at the onset of febrile episodes and on days 3 and 5 from beginning of therapy. The soluble interleukins-6, -8, and -10 were determined in the serum using enzyme bound immunosorbent analysis at the onset of fever and at 24 and 72 hours after initiation of an empiric antibiotic therapy.


RESULTS
The CRP baseline levels differentiated the patients with unexplained fever from those with local infection but did not differentiate them from those with bacteremia. Interleukin-8 at 24 hours differentiated bacteremic from non-bacteremic episodes (P < 0.05) and at a cut-off value of 130 pg/ml it had a sensitivity of 72% and a specificity of 84% to differentiate bacteremia. Interleukin-10 at 24 hours yielded higher values in Gram (-) bacteremia in comparison with the non-bacteremic episodes (P < 0.001) and Gram (+) bacteremia (P < 0.05). Interleukin-6 at 24 hours had significantly higher values in febrile episodes of more than 3 days duration (P < 0.05).


CONCLUSIONS
Interleukin-8 could differentiate in the first 24 hours bacteremic from non-bacteremic episodes in febrile neutropenia, while interleukin-10 is perhaps a more accurate marker for Gram (-) bacteremia.
Spasova
Maria I
MI
Department of Pediatrics and Medical Genetics, Medical University, Plovdiv, 15A Vassil Aprilov St., 4000 Plovdiv, Bulgaria.
Terzieva
Dora D
DD
Tzvetkova
Todorka Z
TZ
Stoyanova
A A
AA
Mumdzhiev
Ivan N
IN
Yanev
Ivan B
IB
Genev
Evgeny D
ED
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016470:Bacteremia / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood / Q000150:complications; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis; D006801:Humans; D007223:Infant; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000097:blood* / Q000188:drug therapy; D009503:Neutropenia / Q000097:blood* / Q000150:complications; D018709:Statistics, Nonparametric
D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10; D002097:C-Reactive Protein