Serum derivative of reactive oxygen metabolites (d-ROMs) in pediatric hemato-oncological patients with neutropenic fever.
BACKGROUND
Early markers for predicting the severity of neutropenic fever (NF) in patients with hemato-oncological patients have not yet been established. Reactive oxygen species are known to play an important role in the antimicrobial function of neutrophils. The aim of this study was to determine the serum levels of derivatives of reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP) levels in these patients, and to investigate the associations between these levels and the severity of NF.


METHODS
Twenty-seven pediatric hemato-oncological patients were enroled in this prospective study. Their median age was 10 years (range 1-19). Laboratory samples for C-reactive protein (CRP), d-ROMs, and BAP were collected at the onset of NF. The Free Radical Analytical System 4(R) was used to measure levels of d-ROMs and BAP.


RESULTS
A total 36 NF episodes were evaluated. Levels of d-ROMs in NF patients with systemic inflammatory response syndrome (SIRS, n = 7) were significantly lower than those in subjects without SIRS (n = 29; 197.6 vs. 314.1 U.CARR, P = 0.017). There were no statistically significant differences in CRP, BAP, WBC count, or neutrophil count at the onset. The peak levels of CRP were significantly higher in patients with SIRS than in those without SIRS (23.9 vs. 6.1 mg/dl, P = 0.0003).


CONCLUSIONS
Patients with low level of d-ROMs at the onset of NF should be observed stringently since they possibly have severe NF.
Nishikawa
Takuro
T
Department of Pediatrics, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. adu44150@ams.odn.ne.jp
Okamoto
Yasuhiro
Y
Kodama
Yuichi
Y
Tanabe
Takayuki
T
Shinkoda
Yuichi
Y
Kawano
Yoshifumi
Y
D000293:Adolescent; D000328:Adult; D000975:Antioxidants / Q000032:analysis / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood* / Q000175:diagnosis; D005609:Free Radicals / Q000378:metabolism; D019337:Hematologic Neoplasms / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D007223:Infant; D008297:Male; D009503:Neutropenia / Q000097:blood* / Q000175:diagnosis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000097:blood* / Q000378:metabolism; D055815:Young Adult
D000975:Antioxidants; D005609:Free Radicals; D017382:Reactive Oxygen Species; D002097:C-Reactive Protein