title: Performance of Interleukin-6 and Interleukin-8 serum levels in pediatric oncology patients with neutropenia and fever for the assessment of low-risk.
abstract: 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.
authors.affiliation: Department of Pediatric Oncology and Hematology, University Hospital of Bern, 3010 Bern, Switzerland. miriam.diepold@insel.ch
authors.forename: Miriam
authors.initials: M
authors.lastname: Diepold
authors.forename: Peter
authors.initials: P
authors.lastname: Noellke
authors.forename: Ulrich
authors.initials: U
authors.lastname: Duffner
authors.forename: Udo
authors.initials: U
authors.lastname: Kontny
authors.forename: Reinhard
authors.initials: R
authors.lastname: Berner
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D015850:Interleukin-6; D016209:Interleukin-8; D002097:C-Reactive Protein; D002442:Ceftazidime