H-ficolin serum concentration and susceptibility to fever and neutropenia in paediatric cancer patients.
H-ficolin (Hakata antigen, ficolin-3) activates the lectin pathway of complement similar to mannose-binding lectin. However, its impact on susceptibility to infection is currently unknown. This study investigated whether the serum concentration of H-ficolin at diagnosis is associated with fever and neutropenia (FN) in paediatric cancer patients. H-ficolin was measured by time-resolved immunofluorometric assay in serum taken at cancer diagnosis from 94 children treated with chemotherapy. The association of FN episodes with H-ficolin serum concentration was analysed by multivariate Poisson regression. Median concentration of H-ficolin in serum was 26 mg/l (range 6-83). Seven (7%) children had low H-ficolin (< 14 mg/l). During a cumulative chemotherapy exposure time of 82 years, 177 FN episodes were recorded, 35 (20%) of them with bacteraemia. Children with low H-ficolin had a significantly increased risk to develop FN [relative risk (RR) 2.24; 95% confidence interval (CI) 1.38-3.65; P = 0.004], resulting in prolonged duration of hospitalization and of intravenous anti-microbial therapy. Bacteraemia occurred more frequently in children with low H-ficolin (RR 2.82; CI 1.02-7.76; P = 0.045). In conclusion, low concentration of H-ficolin was associated with an increased risk of FN, particularly FN with bacteraemia, in children treated with chemotherapy for cancer. Low H-ficolin thus represents a novel risk factor for chemotherapy-related infections.
Schlapbach
L J
LJ
Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Bern, Bern, Switzerland. luregn.schlapbach@insel.ch
Aebi
C
C
Hansen
A G
AG
Hirt
A
A
Jensenius
J C
JC
Ammann
R A
RA
D000293:Adolescent; D016470:Bacteremia; D001424:Bacterial Infections / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D004198:Disease Susceptibility; D005260:Female; D005334:Fever / Q000097:blood*; D015200:Fluoroimmunoassay; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D037102:Lectins / Q000097:blood*; D008297:Male; D009369:Neoplasms / Q000097:blood*; D009503:Neutropenia / Q000097:blood*; D012307:Risk Factors; D018709:Statistics, Nonparametric
D015415:Biomarkers; C109662:FCN3 protein, human; D006023:Glycoproteins; D037102:Lectins