Plasma levels of procalcitonin and eight additional inflammatory molecules in febrile neutropenic patients.
OBJECTIVE
This study aimed to examine the association between different inflammatory markers and specific clinical endpoints in patients with febrile neutropenia.


METHODS
We prospectively evaluated the expression of procalcitonin (PCT), interleukin 8 (IL-8), induced protein-10, tumor necrosis factor alpha (TNF-α), two soluble TNF-α receptors (sTNF-R I and sTNF-R II), monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1 alpha, and eotaxin in 37 episodes of febrile neutropenia occurring in 31 hospitalized adult onco-hematologic patients. Peripheral blood samples were collected in the morning at inclusion (day of fever onset) and on days 1, 3, and 7 after the onset of fever. Approximately 2-3 ml of plasma was obtained from each blood sample and stored at -80 °C.


RESULTS
The sTNF-R II level at inclusion (day 1), the PCT level on the day of fever onset, and the change (day 3 - day 1) in the IL-8 and eotaxin levels were significantly higher in patients who died during the 28-day follow-up. A requirement for early adjustment of antimicrobial treatment was associated with higher day 3 levels of IL-8, sTNF-R II, PCT, and MCP-1.


CONCLUSIONS
Procalcitonin, sTNF-R II, IL-8, MCP-1, and eotaxin could potentially be used to assess the risk of death and the requirement for early adjustment of antimicrobial treatment in febrile, neutropenic onco-hematologic patients. The levels of the other markers showed no association with any of the evaluated endpoints.
Postgraduate Course in Infectious Diseases and Tropical Medicine, Internal Medicine Department, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte/MG, Brazil.
Letícia Carvalho
LC
Neuenschwander
Henrique
H
Bittencourt
Ana Flávia Tibúrcio
AF
Ribeiro
Antônio Lúcio
AL
Teixeira
Mauro M
MM
Teixeira
Jairo Cerqueira
JC
Teixeira
Vandack
V
Nobre
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood*; D015740:Calcitonin Gene-Related Peptide; D002423:Cause of Death; D054413:Chemokine CCL11 / Q000097:blood; D018932:Chemokine CCL2 / Q000097:blood; D054405:Chemokine CCL3 / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000097:blood* / Q000401:mortality; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; C000606589:CALCA protein, human; D054413:Chemokine CCL11; D018932:Chemokine CCL2; D054405:Chemokine CCL3; D015850:Interleukin-6; D016209:Interleukin-8; D011498:Protein Precursors; D047888:Receptors, Tumor Necrosis Factor, Type I; C506235:TNFRSF1A protein, human; D014409:Tumor Necrosis Factor-alpha; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide