Performance of Interleukin-6 and Interleukin-8 serum levels in pediatric oncology patients with neutropenia and fever for the assessment of low-risk
Patients with chemotherapy-related neutropenia and fever are usually hospitalized and treated on empirical intravenous broad-spectrum antibiotic regimens. Early diagnosis of sepsis in children with febrile neutropenia remains difficult due to non-specific clinical and laboratory signs of infection.
We aimed to analyze whether IL-6 and IL-8 could define a group of patients at low risk of septicemia.
Methods: A prospective study was performed to assess the potential value of IL-6, IL-8 and C-reactive protein serum levels to predict severe bacterial infection or bacteremia in febrile neutropenic children with cancer during chemotherapy. Statistical test used: Friedman test, Wilcoxon-Test, Kruskal-Wallis H test, Mann-Whitney U-Test and Receiver Operating Characteristics.
Results: The analysis of cytokine levels measured at the onset of fever indicated that IL-6 and IL-8 are useful to define a possible group of patients with low risk of sepsis.
In predicting bacteremia or severe bacterial infection, IL-6 was the best predictor with the optimum IL-6 cut-off level of 42 pg/ml showing a high sensitivity (90%) and specificity (85%).
Conclusions: These findings may have clinical implications for risk-based antimicrobial treatment strategies.
Author: Miriam Diepold, Peter Noellke, Ulrich Duffner, Udo Kontny and Reinhard Berner
Credits/Source: BMC Infectious Diseases 2008, 8:28
Published on: 2008-03-06
Copyright by the authors listed above - made available via BioMedCentral (Open Access). Please
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