Do Proinflammatory Cytokine Levels Predict Serious Complication Risk of Infection in Pediatric Cancer Patients?

Determination of risk of severe bacterial infection complication in children with cancer is important to diminish the cost of hospitalization and therapy. In this study, children with cancer (leukemia excluded) were evaluated for risk of severe infection complication, success of therapy and the rela...

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Published in:	Pediatric hematology and oncology Vol. 31; no. 5; pp. 415 - 424
Main Authors:	Karakurt, Deniz Guven, Demirsoy, Ugur, Corapcioglu, Funda, Oncel, Selim, Karadogan, Meriban, Arisoy, Emin Sami
Format:	Journal Article
Language:	English
Published:	England Informa Healthcare 01-08-2014 Taylor & Francis
Subjects:	Adolescent Anti-Bacterial Agents - administration & dosage Bacterial Infections - blood Bacterial Infections - drug therapy Bacterial Infections - etiology Child Child, Preschool Cytokines - blood Female Fever - blood Fever - drug therapy Fever - etiology Humans Infant infections Inflammation Mediators - blood Male Neoplasms - blood Neoplasms - drug therapy neutropenia Neutropenia - blood Neutropenia - drug therapy Neutropenia - etiology oncology Penicillanic Acid - administration & dosage Penicillanic Acid - analogs & derivatives Piperacillin - administration & dosage Predictive Value of Tests Risk Factors infections neutropenia oncology
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Summary:	Determination of risk of severe bacterial infection complication in children with cancer is important to diminish the cost of hospitalization and therapy. In this study, children with cancer (leukemia excluded) were evaluated for risk of severe infection complication, success of therapy and the relation between clinical and inflammatory parameters during neutropenic fever attacks. Children who fulfilled the criteria of neutropenic fever with cancer were enrolled in the study. During admission, together with clinical and laboratory parameters; interleukin-6, interleukin-8, soluble tumor necrosis factor receptor II, and soluble interleukin 2 reseptor ve procalcitonin levels were detected. Empirical therapy was started with piperacillin/tazobactam and relation between the inflammatory cytokine levels and therapy response parameters were evaluated. The study population included 31 children and 50 neutropenic attacks were studied. In 48% of the attacks, absolute neutrophile count was >100/mm3 and infectious agents were shown microbiologically in 12% of the attacks. In the study group with piperacillin/tazobactam monotherapy, the success rate without modification was 58%. In the therapy modified group mean duration of fever, antibiotherapy and hospitalization were significantly longer than the group without modification. Inflammatory cytokines' levels during admission (interleukin-6, interleukin-8, soluble tumor necrosis factor reseptor II) were higher in patients with fever >3 days and in multiple regression analysis, it has been shown that they have a determinative role on fever control time. Other cytokines did not show any significant relationship with risk of severe bacterial infection complication and success of therapy.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0888-0018 1521-0669
DOI:	10.3109/08880018.2013.848387