title: Association between serum levels of MASP-2 and neutropenic febrile attacks in children with leukemia.
abstract: BACKGROUND
  Infectious complications are a major etiology of morbidity and mortality in febrile neutropenic patients. Low serum mannose-binding lectin (MBL)-associated serine protease-2 (MASP-2) concentration may represent a risk factor for infection in leukemia patients receiving chemotherapy. This study evaluates the relationship between serum levels of MASP-2 with neutropenic febrile attacks in children with leukemia.
  
  
  METHODS
  This prospective cohort study conducted between 2009-2010, we measured baseline serum MASP-2 levels by enzyme-linked immunosorbent assay (ELISA) prior to chemotherapy in leukemia patients less than 14 years of age. The relationship of febrile neutropenia (FN) episodes and duration of hospitalization with MASP-2 concentration was analyzed.
  
  
  RESULTS
  We evaluated 75 children [38 girls (51%), 37 boys (49%); mean age, 61.6 ± 43.7 months]. There were 8 (10.7%) children with MASP-2 deficiency (< 200 ng/mL). Mean MASP-2 was 673.2 ± 288.7 ng/mL (range: 116-1112). Eight patients had no FN episodes. Of the 129 FN episodes recorded, 19 (average 2.4 times) were from the MASP-2deficient group and 110 (average 1.6 times) were in the normal group. There was a significant difference between the mean MASP-2 concentration and FN episodes (P = 0.043). There was an inverse relationship between FN episodes (r = -0.332, P = 0.004) and the duration of hospitalization (r = -0.334, P = 0.005) with MASP-2 concentration. MASP-2 deficient patients were hospitalized longer than the normal group, which was strongly significant (P < 0.001).
  
  
  CONCLUSIONS
  Our study confirmed the results of several previous studies. MASP-2 deﬁciency in leukemic children treated with chemotherapy was associated with an increased risk of FN episodes, prolonged cumulative duration of hospitalization, and intravenous antimicrobial therapy.
authors.affiliation: Department of Pediatric Hematology Oncology, Pediatric Infectious Research Center (PIRC), Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. shnazari2000@yahoo.com
authors.forename: Shiva
authors.initials: S
authors.lastname: Nazari
authors.forename: Mohsen
authors.initials: M
authors.lastname: Ebrahimi
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Abdollah Gorji
authors.forename: Alireza
authors.initials: A
authors.lastname: Abadi
authors.forename: Alireza
authors.initials: A
authors.lastname: Fahimzad
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005334:Fever / Q000201:enzymology* / Q000209:etiology; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D007938:Leukemia / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D050606:Mannose-Binding Protein-Associated Serine Proteases / Q000032:analysis*; D009503:Neutropenia / Q000201:enzymology* / Q000209:etiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: C105296:MASP2 protein, human; D050606:Mannose-Binding Protein-Associated Serine Proteases