Performance of Interleukin-6 and Interleukin-8 serum levels in pediatric oncology patients with neutropenia and fever for the assessment of low-risk.
BACKGROUND
Patients with chemotherapy-related neutropenia and fever are usually hospitalized and treated on empirical intravenous broad-spectrum antibiotic regimens. Early diagnosis of sepsis in children with febrile neutropenia remains difficult due to non-specific clinical and laboratory signs of infection. We aimed to analyze whether IL-6 and IL-8 could define a group of patients at low risk of septicemia.


METHODS
A prospective study was performed to assess the potential value of IL-6, IL-8 and C-reactive protein serum levels to predict severe bacterial infection or bacteremia in febrile neutropenic children with cancer during chemotherapy. Statistical test used: Friedman test, Wilcoxon-Test, Kruskal-Wallis H test, Mann-Whitney U-Test and Receiver Operating Characteristics.


RESULTS
The analysis of cytokine levels measured at the onset of fever indicated that IL-6 and IL-8 are useful to define a possible group of patients with low risk of sepsis. In predicting bacteremia or severe bacterial infection, IL-6 was the best predictor with the optimum IL-6 cut-off level of 42 pg/ml showing a high sensitivity (90%) and specificity (85%).


CONCLUSIONS
These findings may have clinical implications for risk-based antimicrobial treatment strategies.
Diepold
Miriam
M
Department of Pediatric Oncology and Hematology, University Hospital of Bern, 3010 Bern, Switzerland. miriam.diepold@insel.ch
Noellke
Peter
P
Duffner
Ulrich
U
Kontny
Udo
U
Berner
Reinhard
R
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis; D002442:Ceftazidime / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood / Q000150:complications; D005858:Germany; D006801:Humans; D007223:Infant; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D009503:Neutropenia / Q000097:blood* / Q000150:complications; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000097:blood* / Q000150:complications / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D015850:Interleukin-6; D016209:Interleukin-8; D002097:C-Reactive Protein; D002442:Ceftazidime