title: Human plasma cell-free DNA as a predictor of infectious complications of neutropenic fever in hematological patients.
abstract: Neutropenic fever is common in patients receiving intensive chemotherapy for hematological malignancies. The clinical course may be aggravated by infectious complications like severe sepsis, septic shock or even death. We prospectively studied 100 patients with neutropenic fever and evaluated human plasma cell-free DNA (cfDNA) during the first 3 days after the onset of fever as a prognostic biomarker for complicated clinical course, defined as sepsis or septic shock. Complicated course was observed in 21 patients (21%). There were no significant differences in cfDNA levels between the patients with or without complications on any study day when all the patients were analyzed as one group. In subgroups according to hematological malignancy, patients with acute myeloid leukemia (AML) had lower cfDNA levels than patients with lymphoma. Among AML patients d0 cfDNA/leukocyte ratio and among lymphoma patients d0 cfDNA was associated with subsequent development of sepsis or septic shock. cfDNA deserves further studies in hematological patients with sepsis.
authors: From the 1 Department of Medicine, Kuopio University Hospital , Kuopio.
authors: Anna-Kaisa
authors: AK
authors: Purhonen
authors: Auni
authors: A
authors: Juutilainen
authors: Matti
authors: M
authors: Vänskä
authors: Maija
authors: M
authors: Lehtikangas
authors: Päivi
authors: P
authors: Lakkisto
authors: Sari
authors: S
authors: Hämäläinen
authors: Irma
authors: I
authors: Koivula
authors: Esa
authors: E
authors: Jantunen
authors: Kari
authors: K
authors: Pulkki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000150:complications* / Q000453:epidemiology*; D004247:DNA / Q000097:blood*; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000097:blood / Q000150:complications / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D004247:DNA
keywords: Neutropenic fever; cell-free plasma DNA; infectious complications; sepsis; septic shock