title: Soluble triggering receptor expressed on myeloid cells-1 as an infection marker for patients with neutropenic fever.
abstract: OBJECTIVE
  To assess the value of soluble triggering receptor expressed on myeloid cells-1 as a biomarker of infection in patients with neutropenic fever comparing with procalcitonin and C-reactive protein.
  
  
  METHODS
  Prospective, comparative, single-center study.
  
  
  METHODS
  Hematology ward at a university hospital.
  
  
  METHODS
  Seventy-five patients with neutropenic fever after chemotherapy for their hematologic malignancies.
  
  
  METHODS
  None.
  
  
  RESULTS
  A total of 137 episodes of neutropenic fever in 75 patients were classified into 75 episodes of documented infections and 62 low likelihood of infection. The level of soluble triggering receptor expressed on myeloid cells-1 was significantly elevated in the group of documented infection. The area under the receiver operating characteristic curve for the diagnosis of infection was 0.719 (95% confidence interval, 0.632-0.806; p < .0001) for soluble triggering receptor expressed on myeloid cells-1, which was larger than the values of 0.501 for procalcitonin (0.465-0.657; p = .218) and 0.491 for C-reactive protein (0.394-0.589, p = .858). The fitted marginal logistic regression model of all episodes contained two statistically significant predictors of infection: soluble triggering receptor expressed on myeloid cells-1 (per 1-pg/mL increase; odds ratio [OR], 1.0002; 95% CI, 1.0001-1.0003; p < .0001) and procalcitonin (per 1-ng/mL increase; OR, 1.0094; 95% CI, 1.0005-1.0184; p = .0002). In a diagnostic panel with soluble triggering receptor expressed on myeloid cells-1 and procalcitonin, the sensitivity and specificity were 88% and 48%, respectively.
  
  
  CONCLUSIONS
  Soluble triggering receptor expressed on myeloid cells-1 is better than procalcitonin in the prediction of infection at the onset of neutropenic fever. By applying soluble triggering receptor expressed on myeloid cells-1 and procalcitonin together, low or high risk for infection can be defined at the onset of neutropenic fever.
authors.affiliation: Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Chou-Han
authors.initials: CH
authors.lastname: Lin
authors.forename: Ming
authors.initials: M
authors.lastname: Yao
authors.forename: Szu-Chun
authors.initials: SC
authors.lastname: Hsu
authors.forename: Chao-Chi
authors.initials: CC
authors.lastname: Ho
authors.forename: Ming-Tzer
authors.initials: MT
authors.lastname: Lin
authors.forename: Chih-An
authors.initials: CA
authors.lastname: Lin
authors.forename: Fu-Chang
authors.initials: FC
authors.lastname: Hu
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.forename: Hwei-Fang
authors.initials: HF
authors.lastname: Tien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000378:metabolism; D015740:Calcitonin Gene-Related Peptide; D016001:Confidence Intervals; D005260:Female; D005334:Fever / Q000175:diagnosis / Q000209:etiology; D015972:Gene Expression Regulation, Neoplastic; D019337:Hematologic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008297:Male; D008562:Membrane Glycoproteins / Q000235:genetics / Q000378:metabolism*; D008875:Middle Aged; D022423:Myeloid Cells / Q000378:metabolism*; D009503:Neutropenia / Q000175:diagnosis* / Q000209:etiology; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000378:metabolism; D011971:Receptors, Immunologic / Q000235:genetics / Q000378:metabolism*; D018570:Risk Assessment; D012995:Solubility; D016019:Survival Analysis; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D055815:Young Adult
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D008562:Membrane Glycoproteins; D011498:Protein Precursors; D011971:Receptors, Immunologic; C408842:TREM1 protein, human; D000073871:Triggering Receptor Expressed on Myeloid Cells-1; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide