Could CD64 expression be used as a predictor of positive culture results in children with febrile neutropenia?

Barbosa, Gustavo Göhringer de Almeida; Farias, Mariela Granero; Ludwig, Helena Cocolichio; Stensmann, Isabel Cristina Wiener; Fernandes, Matheus V.; Michalowski, Mariana Bohns; Daudt, Liane Esteves

doi:10.1016/j.bjhh.2015.08.011

Cited by 4 publications

(3 citation statements)

References 25 publications

(28 reference statements)

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“…A correlation could not be identified between CD64 index and positive blood culture. Furthermore, for CRP levels, there was no statistically significant difference between the study groups with positive and negative blood cultures and the control group [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia?

Iris

Yıldırmak²,

Gedık³

et al. 2017

Tjh

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Objective:The aim of this study is to investigate if neutrophil CD64 expression in febrile neutropenia patients could be used as an early indicator of bacteremia.Materials and Methods:All consecutive patients older than 18 years of age who had developed febrile neutropenia episodes due to hematological malignancies were included in the study. Those patients who had significant growth in their blood cultures constituted the case group, while those who had febrile neutropenia without any growth in their cultures and who did not have any documented infections formed the control group. Blood culture bottles were incubated in the Bact ALERT 3D system (bioMerieux, France), identification and susceptibility testing were performed using an automated broth microdilution method (VITEK 2, bioMerieux), and CD64 expression analysis was performed by the flow cytometry method. C-reactive protein (CRP) was measured by turbidimetric methods (Biosystems, Spain) and erythrocyte sedimentation rate (ESR) was measured by the Wintrobe method.Results:In total, we prospectively evaluated 31 febrile episodes. The case group consisted of 17 patients while the control group included 14 patients. CD64 was found on neutrophils of the case group patients with a mean count of 8006 molecules/cell and of control group with a mean count of 2786 molecules/cell. CD64 levels of the case group were significantly higher than those of the control group (p=0.005). In the differentiation of the case group from the control group, a 2500 cut-off value for CD64 had significant [AUC=0.792 (0.619-0.965)] predictive value (p=0.001). In the prediction of patients with a 2500 cut-off value for CD64, sensitivity was 94.1%, positive predictive value was 76.2%, specificity was 64.3%, and negative predictive value was 90.0%. CRP levels and ESR values did not differ significantly between the groups (p=0.005).Conclusion:Neutrophil CD64 expression could be a good predictor as an immune parameter with high sensitivity and a negative predictive value for bacteremia in febrile neutropenic patients.

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Section: Discussionmentioning

confidence: 99%

Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia?

Iris

Yıldırmak²,

Gedık³

et al. 2017

Tjh

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“…The limitations of this study are similar to those previously described in the literature, and, as highlighted by the researchers, it is important to conduct a complementary investigation before reaching definitive conclusions. 9 …”

mentioning

confidence: 99%

“…Despite promising evidence, there is still the need for consistent and reproducible studies to validate the use of these tests and demonstrate that they can be complementary to evaluations based on traditional clinical criteria. 6 , 9 …”

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confidence: 99%

Use of biomarkers in the management of febrile neutropenia episodes in children with cancer

Oliveira

2016

Revista Brasileira de Hematologia e Hemoterapia

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Procalcitonin Clearance, CD64, and HLA-DR as Predictors of Outcome in Febrile Neutropenic Children With Lymphoreticular Malignancies

Gomber

Banerjee

Dewan

et al. 2020

Journal of Pediatric Hematology/Oncology

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Background: Febrile neutropenia (FN) is a dreaded complication of cancer chemotherapy. There has been a lot of improvement in supportive care in FN that has drastically reduced the infection-related mortality in these patients. The focus now is on reducing infection-related morbidity, healthcare costs and optimizing the quality of life of the child as well as their family during these episodes. In this study, biomarkers were studied as predictors of outcome so that outcome can be predicted earlier, and treatment modified accordingly. Objective: To measure procalcitonin levels (at baseline and day 3), procalcitonin clearance, neutrophil CD64 expression levels (at baseline) and monocyte HLA-DR expression levels (at baseline), and their correlation with outcome. Setting: Tertiary care hospital. Study Type: Cross-sectional observational study. Population/Participants: Sixty-five episodes of FN in children below 12 years with lymphoreticular malignancies. Children receiving antibacterial and/or antifungal treatment within the last 7 days were excluded from the study. Methods: The subjects recruited into the study had undergone complete clinical and laboratory evaluation as per hospital protocol. Procalcitonin (day 0 and 3), neutrophil CD64 expression, and monocytic HLA-DR expression levels were measured in these patients. Results: Sixty-five episodes of FN were studied in children with lymphoreticular malignancy. It was found that procalcitonin and HLA-DR are very good markers of outcome, whereas CD64 although a good marker, was inferior to procalcitonin and HLA-DR in predicting outcome. Procalcitonin clearance was found to be superior to single value of procalcitonin. Furthermore, procalcitonin on day 3 was found to be a better predictor of outcome compared with its baseline value. Also, it was found that procalcitonin and HLA-DR had a significant correlation with baseline C-reactive protein levels. Conclusions: On the basis of the findings of the study we suggest that serial monitoring of procalcitonin levels be used in febrile neutropenic children with cancer. Procalcitonin levels on day 3 alone can be offered in resource poor setting. The role of HLA-DR and CD64 also seems promising and needs to be further explored in larger multicentric studies.

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Could CD64 expression be used as a predictor of positive culture results in children with febrile neutropenia?

Cited by 4 publications

References 25 publications

Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia?

Could Neutrophil CD64 Expression Be Used as a Diagnostic Parameter of Bacteremia in Patients with Febrile Neutropenia?

Use of biomarkers in the management of febrile neutropenia episodes in children with cancer

Procalcitonin Clearance, CD64, and HLA-DR as Predictors of Outcome in Febrile Neutropenic Children With Lymphoreticular Malignancies

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