Cytokine concentrations are not predictive of bacteremia in febrile neutropenic patients

Abstract

Assay of cytokines and C reactive protein (CRP) in different periods of febrile neutropenia may be helpful for early defining the risk in severe infections. We determined serum interleukin-6 (IL-6), interleukin-8 (IL-8), soluble interleukin-2 receptor (sIL-2R), tumor necrosis factor alpha (TNF-alpha), interleukin-1 beta (IL-1beta), and CRP in 22 previously untreated patients with various malignancies. Samples were obtained in four different clinical periods of febrile neutropenia; prior to chemotherapy, afebrile neutropenic period after chemotherapy, febrile neutropenic period, and recovery period. When compared to sex-and age-matched group of healthy subjects, IL-6, IL-8, sIL-2R, and CRP levels were found to be elevated in all periods. The highest levels were encountered in the febrile neutropenic period. For predictivity purposes, the afebrile neutropenic period was the most important period. Serum sIL-2R, IL-6, IL-8 and CRP levels were elevated in this period. IL-8 levels showed the most stable elevation through different stages of febrile neutropenia. Serum IL-8 levels were found to have the most reliable and stable elevation in different clinical stages of febrile neutropenia. Nevertheless, IL-8 is not able to discriminate among risk groups and cannot be used as a predictive factor.

Interleukin-5, interleukin-6, interleukin-8 and tumour necrosis factor-alpha levels obtained within 24-h of admission do not predict high-risk infection in children with febrile neutropenia

“…Buyukberber et al, [5] determined serum IL-6, IL-8, TNF-alpha, CRP among other markers in 22 patients with various malignancies. IL-8 levels were found to have the most reliable and stable elevation in FN; nevertheless, it was unable to discriminate among risk groups and was a poor predictive factor.…”

“…IL-8 levels were found to have the most reliable and stable elevation in FN; nevertheless, it was unable to discriminate among risk groups and was a poor predictive factor. [5] Stryjewski et al, [12] demonstrated calcitonin precursors combined with IL-8 (but not IL-6) to be highly sensitive and specific marker of bacterial sepsis in FN. Similar to our results, Persson et al, [18] observed high NPV for IL-6 and IL-8, among other biomarkers.…”

C-reactive protein in critically ill cancer patients with sepsis: influence of neutropenia

“…Several biomarkers, such as IL-6, IL-8, CRP, brain natriuretic peptides, procalcitonin, neopterin, have been evaluated in patients with febrile neutropenia to assess their performance in the diagnosis of infection [18-24], in the identification of the underlying agents [18-20,22,24], in the characterization of sepsis severity and outcome prediction [21,23-27]. However, information on biomarkers comparing neutropenic and non-neutropenic cancer patients are currently limited [28].…”

Use of inflammatory molecules to predict the occurrence of fever in onco-hematological patients with neutropenia

“…A large number of publications have also addressed the usefulness of inflammatory molecules to predict the outcome of febrile neutropenia episodes 23-25. However, very few studies have tested the ability of circulating inflammatory molecules to predict (or anticipate) the occurrence of fever in this population 11,26-29. Engel et al 11 evaluated the ability of serum levels of CXCL8, IL-6 and C-reactive protein (CRP) to predict the occurrence of fever in oncology patients with neutropenia.…”

“…Median circulating levels of sTNFRII, tested on the day before fever, and on the day of fever, were similar 28. Finally, Buyukberber et al 29 analyzed the soluble receptor levels of IL-2 (sIL-2R), IL-6, CXCL8, CRP, IL-1b, and TNF-α in 22 patients with onco-hematological diseases before chemotherapy, and at different moments after treatment. No cytokine was found to be predictive of fever 29.…”