title: Early Changes of Mannose-Binding Lectin, H-Ficolin, and Procalcitonin in Patients with Febrile Neutropenia: A Prospective Observational Study.
abstract: OBJECTIVE
  The significance of mannose-binding lectin (MBL) and H-ficolin deficiency in febrile neutropenic (FN) patients and the correlation of these markers along with consecutive C-reactive protein (CRP) and procalcitonin (PCT) levels during the infectious process are investigated.
  
  
  METHODS
  Patients with any hematological malignancies who were defined to have "microbiologically confirmed infection", "clinically documented infection", or "fever of unknown origin" were included in this single-center prospective observational study. Serum levels of CRP, PCT, MBL, and H-ficolin were determined on 3 separate occasions: at baseline (between hospital admission and chemotherapy), at the onset of fever, and at the 72nd hour of fever.
  
  
  RESULTS
  Forty-six patients (54% male, mean age 41.7 years) with 61 separate episodes of FN were evaluated. Eleven patients (23.9%) had "microbiologically confirmed infection", 17 (37%) had "clinically documented infection", and 18 (39.1%) had "fever of unknown origin". Fourteen (30.4%) patients had low (<500 ng/mL) initial MBL levels and 7 (15.21%) had low (<12,000 ng/mL) H-ficolin levels. Baseline MBL and H-ficolin levels did not significantly change on the first and third days of fever (p=0.076). Gram-negative bacteremia more frequently occurred in those with low initial MBL levels (p=0.006). PCT levels were significantly higher in those with microbiologically documented infections. Mean and median PCT levels were significantly higher in cases with bacteremia. There was no significant difference between hemoculture-positive and-negative patients in terms of CRP levels.
  
  
  CONCLUSIONS
  Monitoring serum H-ficolin levels was shown to be of no benefit in terms of predicting severe infection. Low baseline MBL levels were correlated with high risk of gram-negative bacteremia; however, no significant correlation was shown in the follow-up. Close monitoring of PCT levels is warranted to provide more accurate and specific data while monitoring cases of bacteremia.
authors.forename: Sibel
authors.initials: S
authors.lastname: Işlak Mutcalı
authors.forename: Neşe
authors.initials: N
authors.lastname: Saltoğlu
authors.affiliation: İstanbul University Cerrahpaşa Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, İstanbul, Turkey, Phone: +90 212 414 30 00, E-mail: ilkerinancbalkan@hotmail.com.
authors.forename: İlker İnanç
authors.initials: İİ
authors.lastname: Balkan
authors.forename: Reşat
authors.initials: R
authors.lastname: Özaras
authors.forename: Mücahit
authors.initials: M
authors.lastname: Yemişen
authors.forename: Fehmi
authors.initials: F
authors.lastname: Tabak
authors.forename: Ali
authors.initials: A
authors.lastname: Mert
authors.forename: Recep
authors.initials: R
authors.lastname: Öztürk
authors.forename: Şeniz
authors.initials: Ş
authors.lastname: Öngören
authors.forename: Zafer
authors.initials: Z
authors.lastname: Başlar
authors.forename: Yıldız
authors.initials: Y
authors.lastname: Aydın
authors.forename: Burhan
authors.initials: B
authors.lastname: Ferhanoğlu
authors.forename: Teoman
authors.initials: T
authors.lastname: Soysal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D002097:C-Reactive Protein; D002116:Calcitonin / Q000097:blood*; D064147:Febrile Neutropenia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D006801:Humans; D037102:Lectins / Q000097:blood*; D008297:Male; D037601:Mannose-Binding Lectin / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; C109662:FCN3 protein, human; D006023:Glycoproteins; D037102:Lectins; D037601:Mannose-Binding Lectin; D002116:Calcitonin; D002097:C-Reactive Protein