title: Serum vascular endothelial growth factor in adult haematological patients with neutropenic fever: a comparison with C-reactive protein.
abstract: OBJECTIVE
  Vascular endothelial growth factor (VEGF) is considered to be of importance in patients with sepsis. No data are available on VEGF kinetics in haematological patients with neutropenic fever.
  
  
  METHODS
  Forty-two haematological patients were included into this prospective study. Median age was 57 yr (range 18-70). Fifteen patients received therapy for acute myeloid leukaemia and 27 patients received autologous stem cell transplantation for haematological malignancy. Laboratory samples for the determination of C-reactive protein (CRP) and VEGF were collected at the start of fever (d0) and then daily.
  
  
  RESULTS
  The median serum VEGF concentrations were low in all study patients. In patients with severe sepsis (n = 5) the median VEGF on d0 was higher than in septic patients without signs of hypoperfusion or hypotension (n = 37) (77 pg/mL vs. 52 pg/mL, P = 0.061). Also on d1 the median VEGF concentration was higher in patients with severe sepsis (82 pg/mL vs. 56 pg/mL, P = 0.048). There were no statistically significant differences in CRP values on any day during the study period between patients with severe sepsis and those without. Time from d0 to the peak VEGF concentration (mean 1.02, SE 0.18 d) was shorter than that to the peak CRP concentration (mean 1.93, SE 0.15 d) (P = 0.002).
  
  
  CONCLUSIONS
  Compared to CRP, serum VEGF was a more rapid indicator for sepsis in our haematological patients with neutropenic fever. Those with severe sepsis had higher VEGF concentrations than those without on d0 and d1 after the onset of fever. Further studies on VEGF are warranted in haematological patients.
authors.affiliation: Department of Medicine, Kuopio University Hospital, P.O. B 1777, Kuopio 70211, Finland. sari.hamalainen@kuh.fi
authors.forename: Sari
authors.initials: S
authors.lastname: Hämäläinen
authors.forename: Auni
authors.initials: A
authors.lastname: Juutilainen
authors.forename: Irma
authors.initials: I
authors.lastname: Matinlauri
authors.forename: Taru
authors.initials: T
authors.lastname: Kuittinen
authors.forename: Esko
authors.initials: E
authors.lastname: Ruokonen
authors.forename: Irma
authors.initials: I
authors.lastname: Koivula
authors.forename: Esa
authors.initials: E
authors.lastname: Jantunen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000096:biosynthesis*; D005260:Female; D005334:Fever / Q000097:blood* / Q000150:complications*; D006402:Hematologic Diseases / Q000097:blood* / Q000150:complications*; D006405:Hematology / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood* / Q000150:complications*; D033581:Stem Cell Transplantation; D013997:Time Factors; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D042461:Vascular Endothelial Growth Factor A; D002097:C-Reactive Protein