title: G-CSF therapy and catheter-related Gram-positive sepsis increase serum IL-2 receptor α level and may falsely suggest a relapse in children with soft tissue sarcomas unless serum beta2-microglobulin, lactate dehydrogenase and C-reactive protein levels are determined concomitantly.
abstract: Many components of oncologic treatment increase serum sIL-2Rα level, which may falsely suggest a relapse. We tried to establish whether granulocyte colony stimulating factor (G-CSF) and central vein catheter (CVC)-related sepsis increase serum sIL-2Rα level to values on relapse of childhood soft tissue sarcomas (STS) and how to distinguish real relapse from a "false" one. Serum sIL-2Rα, B2-M, LDH, CRP and ESR levels and rates of markers' elevated values were determined prospectively in 18 STS children: pre-treatmently (ST1), in complete remission (CR; ST2), in CR during G-CSF therapy (ST3), in CR during CVC-related sepsis (ST4), on relapse (ST5) and after treatment (ST6) and once in 50 healthy pediatric controls. It appeared that pre-treatment serum sIL-2Rα, LDH, CRP and ESR but not B2-M declined significantly with remission (ST2) achievement. At ST5 sIL-2Rα, B2-M, LDH and CRP increased from ST2 to ST1 values. SIL-2Rα levels at ST3 and ST4 rose significantly in all patients from ST2 to ST1 and ST5 values. At ST3 also serum LDH and B2-M increased to values at ST1 and ST5 and exceeded significantly those at ST2 and ST4. At ST4 CRP but not B2-M and LDH, rose significantly in most patients to values at ST1 and ST5. Thus, serum sIL-2Rα monitoring in pediatric STS reflects well response to chemotherapy unless samples are collected during G-CSF therapy or CVC-related sepsis. Determination of serum B2-M, LDH and CRP together with sIL-2Rα may help to distinguish between "real" relapse and "false" sIL-2Rα increase due to G-CSF administration or CVC-related sepsis.
authors.affiliation: Department of Pediatrics, Hematology, Oncology and Endocrinology, Medical University of Gdansk, 7 Debinki Street, 80-211 Gdansk, Poland. ewabien1@wp.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Bien
authors.forename: Anna
authors.initials: A
authors.lastname: Balcerska
authors.forename: Maciej
authors.initials: M
authors.lastname: Niedzwiecki
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Krawczyk
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Rapala
authors.forename: Piotr
authors.initials: P
authors.lastname: Trzonkowski
authors.forename: Jan
authors.initials: J
authors.lastname: Stepinski
mesh_terms: D000293:Adolescent; D014408:Biomarkers, Tumor; D002097:C-Reactive Protein / Q000032:analysis; D055499:Catheter-Related Infections / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000097:blood*; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008297:Male; D015375:Receptors, Interleukin-2 / Q000097:blood; D012008:Recurrence; D012509:Sarcoma / Q000097:blood / Q000175:diagnosis*; D018805:Sepsis / Q000188:drug therapy* / Q000382:microbiology; D001613:beta 2-Microglobulin / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; C508017:IL2RA protein, human; D053645:Interleukin-2 Receptor alpha Subunit; D015375:Receptors, Interleukin-2; D001613:beta 2-Microglobulin; D016179:Granulocyte Colony-Stimulating Factor; D002097:C-Reactive Protein; D007770:L-Lactate Dehydrogenase